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41 FELT ST - BUILDING INSPECTION Tc3 -� 0 - 1q ! 2 c« 0 The Commonwealth of Massachusetts FtEGEICES Board of Building Regulations and Standar¢pSpECT NALs RV1OF Massachusetts State Building Code,780 CMR SALEM Rf�,tis4�.{Llar 2011 Building Permit Application To Construct,Repair,Renovate 01paulill�n. One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: Date plied: ! BuildingOfficial(PrintName) Si l� C , gn Date SECTION 1:SITE INFORMATION 1.1 P opirty Ad1lergs�: I 1.2 Assessors Map&Parcel Numbers Ll a Is this an accepted street9 yes_ 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 Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.L c.40,§54) 1.7i 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 OwnerrofRecord• Susan PHH Ss 'konoe✓I Name(Print) City,state,ZIP f:1 1 fGl f No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORW(check all that apply) New Construction❑ Existing Building❑; Owner-Occupied ❑ 1 Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg.❑ 1 Number of Units_ Other Specify: Z7��1".ln�irn.J Brief Description of Proposed WorO: i 616A441 �l�14 SECTION 4-ESTIMATED CONSTRUCTION COSTS Item Estimated Cdsts: Official U O1 (Labor and Materials a Use Only 1.Building $ S —) I. Building Permit Fee:$ Indicate how fee is determined: 2 Electrical $ ❑Standard City/Town Application Fee 1 ❑Total Project Cost'(Item-6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ i List: 5.Mechanical (Fire Suppression) $ Total All Fees:$ Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ / ❑Paid in Full ❑Outstanding Balance Due: MA 2 � t5 I SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) S -7 5�7—7 y 3 License Number Expiration Date Name of CSL Holder Eric W. i',d in List CSL Type(see below)—A— No.and Street Type Description Salem MA 01970 U Unrestricted(Buildings up to 35,000 cu.ft.) Cityfrown,State,ZIP R Restricted 1&2 Family Dwelling M Masomy RC Roofing Covering WS Window and Sidin SF Solid Fuel Burning Appliances _I II insulation -telephone Email address D I Demolition 5.2 Registered Home Improvement Contractor(HIC) ' �� /2 /le ArlaDilf Weatllcrizitrnn, I T C HIC Registration Number Expiration Date HIC Company Name or HIC$ aName Avenue P No.and Street 0I Salem MA 01970 Email address City/Town.State,ZIP 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 I i I,as Owner of the subject property,hereby authorize C.►-, C Ca !M to act on my behalf;i/n/all matters relative to work authorized by this building permit application../ Print Owner's Name(Electronic Signature) Date SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION I By entering my name below,I hereby attesdunder the pains and penalties of pequry that all of the information contained in this phcation r true, to to the best of my knowledge and understanding. y , �51 ' Print Owner's or Authorized Agent's Name(Electronic Signature) Date I NOTES: I. An Owner who obtains a building pemut 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 can be found at w",w.mass.Lovioca Information on the Construction Supervisor License can be found at www.mass.eovldns 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) i (including garage,finished basementlattics,decks or porch) Gross living area(sq.ft.) i Habitable room 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"may be'substituted for"Total Project Cost" i Massachusetts Home Improvement SamDle Contract This form satisfies all basic requiremmm of the states Home bnprovemrnt Contrector Law(MGL chapter 142A),but does pot ivdode standard laoguagetoprotedhOnew"em Secklegaladviceifveeessary. Anyperson planning homeimproveneents should first obtainacopy of"q Massachusetts Consumer Guide to Home Improvement"before agrecvg to any work on your residence.You may obtain a free copy by calling the Office Of Consumer Affairs and Business Reettlatme's Concur er Information Hotline at 617-973-8787 or]-888-283-3757 w oo aw webvtc. Homeowner Information Contractor Iuforanation N Campine Name 'SIu Saw, "N 35 kvn ePi Street Address(dortot a PUUtymc,u.address) Camaaod Salop . > o f St• 61'R Jeff Ave Cily/rown State Zip Cade £ Business Addresc(mustincl4ii:}ppyl�¢e�s)01970 31.4 J711Y111 t"- . Devotee Phone Evening Phme '."t ww Stae Tap Code 97 5. 7k/q-s7z Nailing Address(h dilrerevt from above) Business Phone Fedeal Employer m or S.S.Number law��m tam®n tar Ho�hgv^r�tCa®¢m a4H� agmu. �.P•m rcwmsm aame�• ����g a�,zre� The Cmntroctoragrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,I§taddil I h 'r .) .9� S Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be segued by the contractor as the homeowners agent. be adhered m unless cvcumyaams beyond the contractors manol arise (Owners who secure their own permits will be G excluded from ?m the Guaranty Fund provisions of Z7 Date when contractor will begin contracted nvrk MCL chapter I42A.) ._f141F_Dme when contracted work will be substantially completed. Total Contract Prim and Payment Schedule ��yyrr77�' The Contractor agrees to perform the work,famish the material and labor specified above for the total sum of. Z 5M. (n) Pay�menentnttss)will be made according to the following schedule- S_ _ upon signing contract(not to eeceed 1/3 of the total contract price g the cost of special order items,whichever is greater) S by �r /r1_/_or upon completion of S�V�V/1V7�' by Id 0(�/�or upon completion of �ai S 15 V V- upon completion of the contract. (Law forbids demur " g full payer until contract is comple ed to both parry's satisfaction) The following material/equipmem most be special S to (mdf ordered before the contacted work begins in order te meet the wmPletme schedule.(••) S bepai w NOTES:(•)Includingall finance chmgm(••)La requhm N.any deposit m down-payment required by the cotureetor before work begins mq nor exceed the grater of(a)one-third ofthe total contract price tar(b)the actual cost ofm special equipment w custom made material which mar be special ordered in advance to urea the completion schedule. Ez ras Warr -1 be'bem,Drwidra by the rootr o ❑No❑Ye,In[[terms oron, most b ttoehrd h tin 1 Subcontractors The contractor agrees to be solely responsible for completion of the work described regardless ofthe actions of my third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor Under this amommVern Contract Acceptance Upon signing,this document becomes a binding contract order law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has hem placed on the residence. Review the following cautions and notices carefully before signing this contract • Don't be pressured into signing the contract.Take time to read and fully understand it Ask questions ifsomething is endear. • Make sure the contract h valid H run t C tra9LOrRearistratian The lase requires most home improvement contractors and subeonractOm to be fegrstered wsth the Director ofHome lmprov =t ConV ctorRegistratian. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contraamr for his msrauce company information an that you®confirm coverage,tar ask m see a copy Ofa'yroof of insurance"dacament. • Know your rights and responsibilities. Read the Important Information on the reverse side of this farm and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contrectors normal place of business,provided you notify the contractor in writing at his/her train office or branch office by ordinary mail posted,by telegram seat or by delivery,not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form form explanation ofthisrigbt. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two amliea�iea oftlrc muaxr moo tk mmpkad nod rim One mpr aura5omdeho or.The oWmmpy should4tcpt bd'We mn(mmcryr. Hamemsuer's Signature Contractor s Ignamre 12I I S 1 Date Da e Contractor Arbitration The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as an alternative to court action)if they have a dispute with a contractor. The same right is not automatically afforded to a contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the homeowner by the Home improvement Contractor law. The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractgr may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration-as orbvid A—Ili Massachusetts General Laws,ch C142A. ,V Homeowner's Signature F Contractor's Signature NOTICE:The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. Homeowner's Rights A homeowner's rights under the Home bnprovemmt Contractor Law(MGL chapter 142A)and other consumer protection laws(i.e.MGL chapter 93A)may not be waived in any way,even by agreement However,homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowners who secure their own building permits are automatically excluded from all Guaranty Fond provisions of the Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose. An emmneration of other matters on which the homeowner and contractor lawfully agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about your consumer/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract The contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced documents have been attached Parties are also advised not to sign the document until all blank sections have been filled in or marked as void,deleted or not applicable. One original signed copy of the contract with attachments is to be given to the owner and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties.Contracted work may not begin until both parties have received a fully executed copy of the contract and the three day rescission period has expired. Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However,in instances where a contractor deems him/herself to be financially insecure,the contractor may require that the balance of funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work. Withdrawal of funds from said account would require the simatmes of both parties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of "A Massachusetts Consumer Guide to Home Improvement" contact Consumer Information Hotline Office of Consumer Affairs and Business Regulation 10 Park Plaza,Room 5170,Boston,MA 02116 617-973-8787,888-283-3757 or visit the OCABR website at bttn:Uaawwr.ma�=.."oviac:!I±ri If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractorregistration component of the Home Improvement Contractor Law,contact: Director of Home improvement Contractor Registration Office of Consumer Affairs and Business Regulation 10 Park Plaza Room 5170,Boston,MA 02116 617-973-8787.888-283 3757 or visit the HIC website at han:i.%m wr.masssnviocabri Go online to.view the status of a Home Improvement Contractor's Registration: han:lid'estate.ma.rufionmimnrerrementilicens�-list asn For assistance with informal mediation of disputes or to register fomral complains against a business,call: _ Cotisinner Complaint Section Of fit&fthe Attorney General 617-727-8400 , -- AND/OR Better Business Bureau 508-652-4800,508-755-2548 or 413-734-31 l4 V.i.2.0-urv+mo The Commonwealth ofMassachusem Print Form, , Department oflndustrial Accidents Office oflnvestigattions 1 Congress Street, Suite 100 Boston, AM 02114-2017 i www.mass gov/dia Workers' Compensation Insurance Affidavit. 1$uilders/Contractors/Electricians/Plntnbers IIanlicant Information Please Print I.te Ibiv Name(Business/Organizationftdividual): Atlantic Weathori/ation,LLC Address: 61 K Jefferson Aveme Catem MA 01970 City/State/ ip: Phone#: 9 7 7UJ6 - / r7 Are You employer?Check the a propriate bog: 1. am a employer with� 4. Q I am a general contractor and I Type of project(required): employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have S. Demolition working for me in any capacity, employees and have workers' [No workers' comp.insurance comp. insurrance.t 9. ❑Building addition required.] 5. We are a corporation and its 1011 Electrical repairs or additions 3_❑ I am a homeowner doing all work officers have exercised their 1 I.Q Plumbing repairs or additions myself.[No workers'comp, right of exemption per MGL 12 0 Roo airs insurance required.] t c. 152,§1(4),and we have no // employees. [No workers' 13. 6ther__,T1, L-UI�-,t L J comp.insr.rwnce required.] *Any applicant that checks box#1 must also fill out t #Homeowners who submit this affidavit indicating th he section below showing their workers'compensation policy infomratioa ey are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not thou entities have employees. lfthe sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below information is the policy and job site Insurance Company Name: ` t.1 i t C4 2 / Policy#or Self-ins.Lic.#•_ !l 6 02 70 % 'd I Expiation Date: 1 ✓ z�/ j j/ Job Site Address:_ -� S f l F � — City/State/Zip: �6 e Aai vl 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$I,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up 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. I do hereb fun the!j grad ad o er upy that the information provided above is true and correct S' ature /�Date Phone#: 17 1?- -JY(,i _ 3 Official use only. Do not write in this areq to be completed by city or town ojj?crad City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical inspector s.Plumbing inspector 6.Other Contact Person: Phone#- • -fib�� �� — A CURER UACATEE (OF LDABOLLP y � INSURANCE o i THIS CER-f1FlCATE IS ISSUED AS A - - 03-12-P014 HOLDER. THIS CERTIQA h7ATTER OF INFORNtwTtON ONLY AND CONFERS E DOES NOT AFFIRMATIVELY OR NEGATIVELY FERS NO ----- 'ITS UPON THE CERTIFlCATE AFFORDED BY THE POLICIES 8 END E ' I BELOW. THIS C . 1END OR A e I THE f CERTIFICATE ALTER ISSUING CAVE OF IN THE COVERAGE!G INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFlCATE HOLDER. BETWEEN i I IIIANT: If the certificate holder is an ADDITIONAL subject to the terms a INSURED,the Dolicv les and mu conditions of policy,certain policies may require endo Bement A statement an this ON t5 tNA1VED, not corder rights to the certificate holder in lieu of such endorsemMay r. certificate dons PRow.lc� t 'cc.•rrACr EASTERN INS GROUP LLC 233 WEST CENTRAL ST - PHGVE NAiICK,MA 01760 PAX _ 1 `iUruc e- rAiC vm- 1 RISVRER(S)AFFORDING COVERAGE INSL'R�.RA:ALIERIc,,2UNCH IrrsU. NAIL_ 1 tiSL'RED 4rWCE-.:CIIPANy ATLANTIC VVE—ATHERIZATION LL67 C 4 nvsGRER e: SALEM.R JEF=ERSON AVE I SALEtd,MA 07E70. �INSJRER D: I I 1 �It'SJR'vT I I COVER C-FS IN'y'JR�F: I CE IFICA U B R: THIS IS TO CER71:Y THAT THE POLICIES OF INSURANCE LISTED 2ELOW HAVE B REVi ON g R_ ABOVE FOR THE POLICY PERIOD INDICATcD. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF AI\IY COM1TRACI OR OTHER DOCUMENT W)TH RESPE BEEN ISSUED TO THE INSURED Ngh,_cD I INSURANCE AFFORDED BY TH CT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE I CONDITIONS OF SUCH POUCIES.LIMfTS S OWN MADESCRIBED NADE HEREIN REDUCEDy PAID CLAIMS. E TERMS, 1t1sREXCLUSIONS AND L7.� TYPEOFINSURANCE ADD SUB��VV POUCY� POLICY E.VP I GENERAL LmsiuY INSR 1VVD1 POLICY NUTAam , u ( COMML, DRYY)7 A;F.LR) UrAns ' T CNL GENEPJ:LLW31L EACHoCCURR_NCE jCL:IL1r!!ADE❑ OC/aJR I DCSAGe S-_PTOiA iEp S FJ_D drP rAri mep,u=m S r Ito PERSONALa ADVIN,1URy s ! °NL AGGflEG;.i�e L0.UTAPPUES Jac. PER: 1 _ OcNERAtRGG3EO-T� IS POLICY PRO. I� OC FRODUCrs- ' L 1 1 CC1APaDPAGC- $AUTp:h08I1.ELIABe.ItY { _.:VYALRO I s I ` GFD j ALL CANED "-HEDULE a5i:xic ELVGLE UNIT p a amen,n > 4r0's A{!ip$ i B.:DILV IIuIURY IPm Amp LR OAGTCS p KCVdVNE ) IS i AUrps 4 BODILY INJURY[Per xgyWl) S IU j I; I I :FSO. - I I LtaR= is OCCLH s I j �ESC s$LIAe culF�.rasDs I IEACHCCCURRENce Is I DEDI RTW1043 - AGGR=GATE S t 'A AND R3 COUPENSATPJFF 11 I I I I EI FLOYE-RS UAINUrY \ Ra I Oi.?arn_R_ Curry-f j Vic S ATL O-;`:CFRnaE:3ER_-%CLVOEOT InrI N:A� � ITORY LA.IrsER (:!aa:x:cy sr.Fa] s••� 6ZZU6 I03-20-2014 03.2G.2015 EL-E�ACCID- `500,000 a es,cpsaaenr.Ce, 58270127 I G_SCRIPrIONOFOPERATION } I EL DISEASE-EA EFJPLOYEEI•SSOO,000 i I I FI-01SEASE-17MICYLII'm $500,000 DESCRIPnDR OFOPEAATIpNSlLOCAnONSt y4pnee(AIFaM ACORD 101,Admilzml Rammt¢SdmdUb Nmams Ls regWrarO I I I i I I 1 i CERTIF CATE HOLDER CITY OF SALEbf CANCELLATION f f ?31hrASHINGTOty ST SHOULD ANY OF THE ABOVE DESCRISED POLICIES BEj ! SALEM MAD 1g70 CANCELLED BEFORE THE MIPIRATION DATE THEREOF,' ;NOTICE VALL BE DELIVERED IN ACCORDANCE V?iTH THEI I POLICY PROVISIONS. iALTF:pRn_p REPRESEf TAnYa rJ � _ ACORD 25(2010(135] ^{ ©1980-2010 ACORD CORPORATION.All rights reserved' The AC name and logo are registered marks of ACORD CiRTMCATE OF CERTIFI�CA�CERTIFICATE IS NOTU�AS A MA aB�6 IR9Sp� ��� TTER OF INFORprygT10N ONLY nATEnALw BELOIM. THIS CERTIFICATE #, TI ELY OR NEGATIVELY AMEND, AND CONFERS NO RIGHTS UPON 3/10/2014 REPRESENTATIVE OR PRODUC RANCE DOES NOT CONS TI 67tTEND OR ALTER THE COVERAGE CERTIFICATE HOLD IMPORTANT: If RI AND THE CERTIFICATE HOLDER A CONTRACT B t/ERAGE AFFORDED By THIS thethe certificate holder Is an ADDITIONAL INSURED, the ETfVEEN THE ISSUING INSURERS THE POLICIES Certificate to holder in Iheu ofsutch Poll ,Certain Laineme , ( �' AU�ORIZED P Y Ymin policies may require an endolrsemenl u t eteendo se EFTS 1 A be endorsed, If SOBROGATION IS WAIVED,subject to PRODUCER certificate does not confer rights to the ':Estero Iasttraaee Group yT,C couracr 233 West Cea NAM . Constrnctyoa trill Street PHONE (DSO$ eatAa j 651-7700 pq� Natick - AOOResac I N0 INSURED 01760 ! INSURER IHSURERA,ar>; AFFORDING COVERAGE Atlantic walath SI AFFORDING NAICa 61 Re?-r J f_ son2ation INsuRERe>�rbella Indemni oa Co. 1360 e_rersoa Avenue INSURER CNauti7us Ins Las Co. {100i7 SalemwsURERO: tlrarLce Co COVERAGES 01970 ', wsuRERE- 'THIS Is TO CERTIpy THAT CER i7FICATE NUMBER t1as INSURER F: INDICATED NO THE POLICIES ' INSURANCE LISTED BELOW2O19 CERTIFICATE TtAATHSTgsu OR rypING ANY REQUIREMENT, HAVE BEEN ISSUED TO THE tNSUREDSION NUMBER:EXCLUSIONS AND CONDIT0 S OF SUCH PpLiTC S LIMTER U 0ACONDITION FFO D By CON. TRACT OR OTHER DOCUMENT 90VE FOR THE Cy PERIOD TYPE OFINSURANCE A o THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED H WITH RESPECT HAVE BEEN RPou BY PAID CLAIMS EREIN IS SUBJECT 70 ALL TtMEt i WAS. GENERAL UAa1LITY . H THIS POLICY tNtdeER POLICY PoDCY P % COMMERCIAL GENERAL '4'VDD UAO e CIA9ILIN Urars C'-^R OV-4ADE a]OCCUR EACH OCCURRENCE s 1,000 500042816 ARA R ,000 /20/2019 11/20/203-9 PR ES Is FIFO EXP IAn one ?soot IS 50,000 GENL AGCRECA -E U611TAPPLIES PERSONAL 3 S,000 POucY Pao P� ADV w�uRr s 1,000,000 LCC - GENERAL AGGREGATE AUTOMOSILE LLASIUTY s 2,00o,000 PROOUCTS-COw1op AGG S ANY 2,000,000 $ ALL OWyED LEOIA81 s AUTOS n AUUTUI'E0: !!Ea IN TOSS GLE UD HIRED AUTOS a. ANO�N0-0'ANED ! 02001587E i dODiLY INNRY perl S 1 000 OQp /20/2014 ! /20/2025 a00i1Y INJURY(Perapy'' e1nt S X UMBRELLA UAS v PRO PERTY er a denn E s ZL E:CESS CUIB OCCUR I CLAUA Ile-Basic S.IAAOE s B 000 °EO I RETENnoxs CH OCCURRENCE WORKERS COTJpElISA7R)N 600D58654 AOGRECA7F Is 1,000,000 ANT PRO AND EMPLOYERS'LIABILITY �/20/201e /20/2015 I s 11000,000 Cr'rICE whs,pRiEi O.R/PARiNERGX_OUO� YIN (Ltandworys ry�EXCLUDED? NIA +YC STATII- Is IP25 d t ❑ I OTH. 0fscrtl-P�"rlONO OPERAnoNseec„ cL EACHACC105VT s - PO�D`PION LIP+BiLITP _ � EL OI5E5sE_= -A ELtPL01^�s �L200378602 �011/2023 EI pISEAg_FOUCY UI.IR 5 IIIII 0/1/2019 tSCWPiTONOFO GENERAL AGGREGATE PERATIONS ILOCATONS IMUC I EA POLLUnON CONOmON $1,000,Don L�(ABach ACORo101.A¢dIU ..IRanarin se0ed0lg Umore ' $1,000 spas is�regW" ,000 RTIFICATE HOLDER CANCELLATION CITY OF, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED SAIPFM THE EXPIRAflON DATE THEREOF, ISI WILL BEED BEFORE S-'LEef, T^-a 01970 93 RRINGTON STREET ACCORDANCE VLgTH THE POLICYP NOTICE ROVONS, DELIVERED IN AUTHORIZED REPREEEtt0.T1rE f RD 25(2070/06) I Ronald Cleaves/� A 5 nnanetnm i sl,e nr-.nRl1 n�.,,e�nrL I m 79BB 2010 ACORD CORD 'Turn ern r�nfryc fpH p plrc of aP.ARiT ORATION• All rights rase Ned, tit Massachusetts -Department-pf public Safety f Board of Building Regulations and Standards Construction Supers isor License: CS-087977 ': i FMC W PALM 3 HELTON ST Salem MA 01970: - P J..G..+•� .n ,,:0 Expiration Commissioner 04/23/2016 . C�e`(fouriiroirrrxvil/�rz�C/��a.�Jrrc�rue/(1 } _Office of Coasomer Affairs&Business Regulation ! M a'Con IMPR VEMENT CONTRACTOR i gistrationc 142089 Type: piration. 3/1212016 - Ltd Liability Coipoc ATLANTIC WEATHERIZATION'L:LC. �e ERIC PALM 61RJEFFERSONAVE SALEM,MA 01970- Undersecretary '.. _