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HomeMy WebLinkAboutBuilding Permit # 2/6/2017 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received Permit No#:Ll) ate Issued: LI ) D z. z L7 BIPORTA-NT. Applicant must complete all.items on this page nnt, f IkL61, d5ME R 46 P R Q P En.R-T,Y . F(6) �y Pnnti i 0M, "UCI PARCEL IVIAPON INDISTRICTS HisibrI&lbi_i�tbbt Machine TYPE OF IMPROVEMENT PROPOSED USE TYPE -Non- Residential LL 0 New Building U-0ne family N Building rEol Addition El Two or more family I-] Industrial 4J,alteration No. of units: El Commercial P-Repair, replacement El Assessory Bldg 11 Others: El Demolition 0 Other t z el P 8[i! IT] Li P r DESCRIPTION OF WORK Tr, BE PERFORMED: ep, x Lg ,lease Type or Print Clearly' OWNER: Name._ a , —----- Pho.n.q. Address: to r, d hl �7 v 1-2 1. Address rrse� IMP, n § C -v P (D up isb� ons ruo i Date Impravman ense; F�i a e r ARCH ITEC"17E N G I NEERPhone:­ Address, Req. Mo. FEE SCHEDIJI-E. BULDRIIIG PERNIT.$12,00 PER$1000-00 OF THE TOTAL ESTIMATED COSyf2ASED ON$125,00 PER S.F. �.____Jotal Project Cost: 0-0. FEE: $ -_91;,;Z 1 Check No.: �2_L( Receir)t No.: INO JIE: ,Per, 11S 0),11 e wiffil unregistered confractors t10 notha �e- cces t tZle guarantyfiind 7-7 Plans Submitted ❑ Plans Waived ❑ Certified Piot Plan ❑ Stamped Plans ❑ F EWERAGE DISPOSAL r ❑ Tanning/Massage/Body Art ❑ SwirrFming Pools❑ Tobacco Sales ❑ Food Packaging/Sales ❑ PAvate(septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL. SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature .COMMENTS CONSERVATION Reviewed on Si nature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeais: Variance, Petition No: Zoning Decisionlreceipt submitted yes Pianning Board Decision: Comments Conservation Decision: Comments Water & Sewer Con neotionls nature & Data Driveway Permit DP's Town Engiucer: S9gnatare: Located 384 Osgood Street l FIRE DEPARTMENT' -.Temp Dumpster on site yes no Lueated at 124 Main Street Fire Department s ign/aturelldate Y / p 411117 NORTH Town of Andover ® •i 0 No. -mom% M I 194 Very x.59 i VeL Co[sW[Ne w1[1[ v' � 4.1 BOARD OF HEALTH ijE ' M I ][ L111111111110 Food/Kitchen Septic System THIS CERTIFIES THAT ....... . . r .......... BUILDING INSPECTOR has permission to erect .......................... buildings Foundation on . .... �l 0 .,. ,.,.., Rough to be occupied as Chimney provided that the person accepting this permit shal In every respect conform to the terms of the applications ;nal on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and ,� Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMITEXPIRES IN 6 MONTHSELECTRICAL INSPECTOR UCONSTNLESS Tl Rough Service Final BUILDING IN CTO GAS INSPECTOR ccupancy Permit required to Occupy_By Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. 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The actual costs of construction may be higher, equal to, r lower than the cost estimated by the Contractor. This is not a"fixed price" or guaranteemaxium price the Owner is responsible d to pays for actual under guaranteed maxiinum amount. Rather, or and for comparing expenditures to the amounts estimated expenditures by the Contract by the Contractor. to subcontractors and suppliers 3. Co Owner will pay all invoices directly, and will pay the general Contractor a fee of 20% of all total invoices. is permitted to review the material purchase receipts and 4. iting; The Owner subcontractor invoices each time the Contractor submits a monthly pbarefilgll should yvecause there is no fixed price or guaranteed maximum price, the Owner payment applications and supporting documentation. In addition, lien release forms have been provided as Exhibits to the Document, 5, Bonds Insurance: The Contractor and Owner are to contact their insurance agents _ before signing this contract to make sure all the insurance requirements are met. The Contractor is required to provide insurance to the Owner insure the Work while in progress. check the status of each potential subcontractor's insurance. Additionally, the Owner is to Contractor's Wan-an In the documents, the Contractor warrants to te Owner that ,ee of matehrial stnictural the Work will be in accordance with contract documents and ft defects, done so In m 7. Revisions: if revisions are to be made to this contract, they should be writing. IZP `IDELN f]f IAL COIF. 'I:I IICT. QNT 2AC_:T LCUt Plxxs) Parties: DC Development & Construction, LLC l 1 100 Hale St. J Ilaverhill, MA 01830 Contractor Manor Realty Trust Lucy Munyi and Samuel Kimungu, Trustees 2 Woolsack Dr. Westford, MA 018€16 Owner Property: 440 Great Pond Rd. NorthAndover, MA 01815 Date: 12/7/16 LI Coiztractor's Duties. Contractor shall manage, hire and order on behalf of Owner. the material, labor, equipment, tools, and supervision (the "Work") necessary to construct a single farnily residence (the "Project") for Owner on the Property in compliance with the plans and specifications supplied by Owner(the "Plans"). The Plans are attached as I±:xhabiit A. This Contract and all of its Exhibits, and all Change Orders after execution,are the"Contract Documents." Contractor agrees to immediately inform Owner in writing of any discrepancies, errors, or omissions in the Plans or materially changed or unanticipated conditions and not to proceed with any work affected by such discrepancy until Owner directs Contractor to do so. 1 12 Permits. Contractor shall obtain the governmental approvals of the Plans and all perinits for construction of 1he Project. Owner is responsible for cost of the building permit and other necessarypermits. II. pRICE AND PAY ?1-T 2,1 stirnated Project Gost. Contractor estimates the total cost of the Work to be "1"\vE� Million. One Hundred Fifty-two "Thousand, Fifty Dollars ($2,152,200.00) as set forth hi Exhibit 13 (tire "E,stilliated Project Cost"), VIC Estimated Project Cost is organized by trade categories and systems. ["Al-iibit 13 is an estimate only and it is based upon the Plans provided by Owner. Tile actual total cost of the \Vork may be higher or lower tilari the E stiruated Project Cost. of .11le Work Cost S�Uus_riee .) owner shall pay Contractor for the 2,2 The Cost __y (Cq. performance ofthea sum, equal to twenty percent (20%) of the Actual Costs of the total invoices paid to subcontractors and suppliers (tile "Contractor's Fee"), plus sales tax. Owner shall pay all Suppliers and subcontractors directly, including any deposit required by any subcontractor or SLIJ)PHU prior to the coilirilericeinerit Of the subcontractor's work or suppliers purchase. "Actual Costs" include the following: (a) On-site Project personnel costs, but limited to those persons necessary for the proper performance of the Work, at the following hourly rates: (list by job title and hourly rate) (b) The costs paid for the purchase, installation and/or use of all materials, structural accessories, machinery, equipment or other items for the performance of the Work; (c) The costs paid for all insurance and governmental fees and permits for the Project: (ci) 'file costs paid to subcontractors for their perfon-riance of the Work; and 23 L a down payment of _Rqylllqiit. Owner shall pay Contractor commencement of the Work. The dog Woke-d-ILIgusan.d Dollars ($100.000.00) prior to conn payment shall be credited against the Cost of the Work beginning with Contractor's first Progress Payment. Owner has sufficient funds, either personal or through lender financing, in an amount equal to the E.stimated Project Cost. 2A progrcK1 _Paynents. On the first business day of every month, Contractor shall present to Owner an Application for Payment based on the Actual Costs incurred to that date plus the Contractor's Fee and plus sales tax, less previous payments. Owner shall pay the full amount billed, no later than five (5) calendar days from the date of' receipt of each Application for Payllicrit. With each Application for Payment the Owner shall have the right to require Contractor to provide documentation to support those Actual Costs. Contractor shall apply Owner's 1),ayrilcilt only to the costs and fees of this Project. Project Costs. if Contractor 15 kriticipa L _�L _led, Actual Costs E3�,cceding Estimated reasonably believes that anticipated Actual Costs will exceed any Work component of the Estimated Project Cost in Exhibit B by more than ten percent (10%), then Contractor shall give prior written not,ice to Owner of the anticipated increase before completing that Work component. 2.6 Retain ge. Owner shall not withhold retainage from progress payments. 2.7 Lien Release. Owner shall not be required to make any payment to Contractor unless and until Contractor provides Owner with an ttnconditional waiver and lien release foam signed by Contractor, Owner shall not be required to make any payments to subcontractors unless and until each subcontractor who is claiming Two Thousand Five Hundred Dollars ($2,500.00) provides Owner with an unconditional waiver and release form signed by subcontractor. Exhibit C-1. 2.8 Final l? ty nent. Within ten(10) days after Contractor notifies Owner that the Wont is Substantially Complete, Owner shall inspect the Work with Contractor and deliver to Contractor a comprehensive list of items to be completed or corrected (the "Punch List"), The Punch List and other Work shall be finished by Contractor within thirty (30) days of Contractor's receipt of the Punch List. Final Payment shall be due when the Contractor provides the Owner with final lien releases from Contractor and all subcontractors and suppliers, conditioned only on receipt of Final Paynnent attached as Exhibit C-2', "Substantially Complete" or "Substantial Completion" means the stage in the progress of the Work when Owner has legal occupancy and full and unrestricted use and benefit of the Project for its intended purpose with only minor incidental work or correction or repair remaining to be performed by Contractor. 2.9 Failure of Payment. If Owner fails to pay Contractor amounts due within five (5) days of the time required by Section 2.4, Contractor may, upon providing seven (7) days written notice to Owner, suspend the Work until the amounts due have been received, If the failure of payment remains uncured'for five (5) days after the first written notice, Contractor may terminate the Contract. Payments due and unpaid under the Contract Documents shall bear interest at the rate of t� clve percent(12%) per annum from the date payment was due until paid, 111. CHANGES 3,1 Natcue of Clnan�_e. If Owner or Contractor requests, or one of the parties believes that a change is necessary, (a"Change"),then the parties shall comply with the following procedure to reflect a Change in the Work; a, The Party requesting or noting the Change small write a description of the Change and give the other Party that writing (the "Change Notice"), b. Before proceeding with the changed work, unless excused by an emergency involving safety or property damage, the Contractor shall provide Owner with a fixed-price written estimate of the cost and time impact of the requested Change; C, Owner and Contractor shall execute a Change Order confirming them agreement with the Change, the fixed-price cost, and the extension of the Substantial Completion date, if any. If the Change cannot be performed on a fixed-price basis, the Change Order shall identify the agreed method of compensation. d. Owner shall pay the Contractor the total cost of the change order prior to any work being commenced pursuant to the work order. 3 2 Cliam Order Format, A blank Change Order form is included in this Contract as Exhibit E. IV. SCHEDULE 4,1 Commencement and Completion of the Work. Contractor shall commence the Work within ten (10) calendar days of receipt of a building permit and down payment. Subject to the permitted extensions and;delays provided herein, Contractor shall Substantially Complete the. Work within fifteen months (456) calendar days after the commencement date. With its first Application for Payment, Contractor shall provide a schedule indicating proposed subcontractors' activity sequences and durations, deadlines for Owner's decisions on material selections. and milestones for delivery of materials, The schedule is included in this Contract as Exhibit F, 4.2 Construction :Time and Liquidated Damages. Contractor agrees that the time in Section 4,I to reach Substantial Completion, as reflected by Contractor's schedule; provides sufficient time for the expeditious and practical execution of the Work. 43 Delay_. if the Pro eet is delayed by the act, neglect or default of Owner, Owners agent. Owner's design professional, Owner's lender, governmental action or inaction. any contractor employed by Owner, any materials supplier acting for Owner, or any other reason or reasons beyond Contractor's reasonable control, including without limitation damage caused by fire or other casualty, strikes, force majeure, shortage of materials or labor, transportation delays. weather conditions, change ,orders, or deficiencies in the Contract Documents (the "Excusable Dela),'),then the Substantial Completion date shall be extended for a period reasonably equivalent to the time lost by reason of such delay, 4.4 Notice of Delay. Within a reasonable time following the date Contractor knows. or within reasonable diligence should know of an Excusable Delay, but in no event longer than seven (7) days. Contractor shall notify Owner of the extension of time resulting from such delay. "I'he extension of time shall be based upon Contractor's reasonable determination of the delay period. Any time extension to the Substantial Completion date shall be documented in a Change Order, V. INSURANCE Before commencing the Work and as a condition of payment, Contractor shall purchase and maintain insurance as described below from an insurer admitted to do business in Massachusetts, that will protect it from bodily injury or property damage claims arising out of its operations under this Contract, whether the operations are by Contractor, Contractor's consultants or subcontractors, anyone directly or indirectly employed by any of them. or by anyone for whose acts any of thein may be liable. 1, Commercial General Liability (CGL) insurance providing bodily injury liability and property damage liability with combined single limits of not less than $1,000,000 per occurrence, and $2,000,000 general aggregate limits, and Products/Completed Operations aggregate limits of $2,000,000, written oil an occurrence form. i 2. Automobile liability 'insurance with a minimum limit of liability of not less than $300,000 per occurrence for all owned, non-owned and hired automobiles. 3. if the Owner requires that Contractor's general liability policy be endorsed so that the aggregate limits of insurance apply on this job, both parties mast check the appropriate box: Owner C } Contractor ]. 4. Owner shall be included as an additional insured under the CGL policy. Prior to starting work, Contractor shall provide a copy of the actual additional insured endorsement or blanket additional insured policy wording to the CGL policy that documents the Owner`s additional insured status. Unless otherwise agreed, Owner shall secure and maintain property insurance upon the Work to its frill insurable value (replacement cost) including the peril of theft and, including materials delivered to the Property (whether those materials are actually incorporated into or adjacent to the Work), miscellaneous materials and supplies incidental to the Work and temporary structures. if work is to be performed on an existing residential structure, the Owner may retain an all risk homeowner's policy and delete any exclusion to theft of building materials. Owner's policy limit must be increased to contemplate the value of the existing structure and.improvements to be added. Owner and Contractor hereby waive their rights of subrogation against one another for any losses covered by the required insurance policies except that Contractor shall be liable Ibr the property insurance deductible if a claim is made against such property insurance and that claim arises out of Contractor's negligence. X11. CONTRACTOR'S WARRANTY Cil Contractor's Warranty, Contractor warrants that the Work shall be in accordance with the Contract Documents and free from material structural defects and shall return and repair any Work not in accordance with the Contract Documents for a period of one (1) year from the date of Substantial Completion of the Work (the "Warranty Period"). All product warranties, if any, are deemed assigned froze Contractor to Owner. C2 Cure of Defect. If a defect is discovered within the Warranty Period, then Owner must promptly notify Contractor in writing following the discovery of that defect (the "Warranty Defect Notice") and must provide Contractor with an opportunity to inspect and an opportunity to either cure the defect in a manner customary in the industry or to pay to Owner the cost of repairor replacement of the defect as estimated by Contractor. This Warranty Defect Notice shall serve as the written notice of claim described in the following paragraph. In no event shall Contractor's liability exceed the fair and reasonable cost of repair or replacement of the warranted defect. Contractor shall not be liable for any cost or expense incurred by Owner in remedying any warranted defects unless Contractor has been notified in writing and has been afforded the opportunity to cure the claimed defect or to pay the sums specified herein,Nothing contained in this section shall be construed to establish a period of limitation with respect to Contractor's other obligations tinder the Contract Documents G I.ir-litation of Damages. Contractor and Owner waive claims against each other for consequential damages. This Mutual waiver includes,but is not limited to: (a) damages incurred by Owner for loss of income, profit, financing, business, and reputation; and (b) damages incurred by Contractor for losses of financing, business and reputation, and for loss of profit except anticipated profit arising directly from the Work, 1 llis mutual waiver is applicable, without limitation, to all consequential damages due to either party's termination in accordance with Section 9. Nothing contained in this Section 6A shall be deemed to preclude an award of liquidated damages, when applicable, in accordance with Section 4.2. If any court determines that this section or its application to any person or circumstance is, to any extent, invalid or unenforeeable, the remainder of this Contract shall not be affected thereby and each other term, covenant or condition of this Contract shall be valid and be enforced to the fullest extent permitted by law. VII. SAFETY Contractor and its subcontractors shall take all reasonably necessary safety precautions. including compliance with; applicable laws, ordinances, regulations, and orders issued by a public authority, whether federal, state, or local. Contractor shall at all times be responsible for providing a safe job site and be responsible for the work performance and safety of all employees, personnel. equipment, and materials within the care, custody, or control or Contractor or its subcontractors of any tier. Contractor and its subcontractors shall furnish all required safety equipment and ensure all of its employees and lower-tier subcontractors' employees have and wear personal protective equipment in compliance with applicable safety requirements. Contractor shall promptly provide Owner with written notice of safety hazard(s) or violation(s) found on the job site or of any injury to its or its subcontractors' workers incurred on the job site. V111. IL4DEMNITY Contractor agrees to defend, indemnify, and hold harmless (tile "Indermnity Duty'") Owner and its agents from and against claims, damages, losses and expenses, including but not limited to attorneys' fees and costs and expenses, arising out of or resulting from performance of the Work, provided that such claim, damage, loss, or expense is attributable to bodily iniury. sickness, disease or dea h, or to injury to or destruction of tangible property (other than the Worl< itself) (tile "Harm"), pr vided, however, that the Contractor owes no Indemnity Duty if the 1-farm was caused by or results from the sole negligence of the Owner or its agents or both, and provided further that in the event of concurrent negligence (i) by Contractor or the Contractor's subcontractors agents o employees, or both and (ii) by the Owner or its agents, or both, then the Contractor's Indemnity Duty is valid and enforceable only to the extent of the negligence of Contractor, its agents, a id its employees. JX. TERMINATION 9,1 T_ernlina ion by Owner for Cause. Owner may, after giving Contractor seven (7) days written notice and an opportunity to commence and continue to cure the alleged cause. terminate the Contract i Contractor violates any material provision of this Contractor, {a) refuses or fails to supply enough properly skilled workers or prober materials,or (b) persistently disregards laws, ordinances, rules, regulations or orders f public authorities having jurisdiction. 92 Termina ion by Contractor for Cause. In addition to Contractor's right to terminate the Contract pursuant W Section 2.9, the Contractor may terminate the Contract for cause if the Owner breaches any material provision of the Contract Documents. Prior to terminating the Contract for cause Land r• this Section. Contractor shall first provide Owner seven (7) days written .notice of the alleged breach. If Owner fails to cure the breach within seven (7) days of receipt of Stich notice. or fails to commence and diligently continue with cure efforts if the breach cannot reasonably be cured wit lin seven (7)days,the Contractor may terminate the Contract. X, MEDIATI N The parties agr e to attempt to resolve any dispute through good faith negotiation as a condition precedent to ornmencing litigation, except where commencing litigation is necessary to preserve lien or other similar rights, If negotiation is not successful, then before beginning any legal proceeding, other than o enforce this Section, the parties agree to engage in non-binding mediation conducted by a rnediat r selected by them and in accordance with the Massachusetts State version of the Uniform Mecli tion Act. Unless the parties agree otherwise, the, mediation will be in accordance with the Iorne Construction Mediation Procedures of the American Arbitration Association ("AAA"). Either party may give written notice to the other party requesting mediation and the parties agree tc use their best efforts to conduct the mediation within sixty (60) days of the notice. The parties will share the cost of media#ion equally. The mediation notice and mediation process are not a condition to satisfying the notice requirements identified in Section 6 of this Contract or the recordi ig ofa mechanics' lien. XI, GENERAL l 1.1 Survival In the event any clause or provision of this Contract shall be held to be invalid, thin the remain ng clauses and provisions shall nevertheless be and remain in full force and s effect. i d 11.2 Entirereerxient. The Contract Documents contain the entire agreement between the parties with respec to construction of the Project. All other agreements, oral or written, are hereby merged into anc superseded by this Contract. There are no other agreements which modify Or afi'ect the terns her of. No amendment hereto shall be binding unless the terms thereof are in writing and signed by b th parties. No verbal or other agreements modify or affect this Contract. 11.i Binding Effect, This Contract shall be binding upon the parties hereto, and their heirs, successors, execu ars, administrators and assigns. 11A Assignn ent. Neither party shall assign nor transfer this Contract or any rights hereunder without the prior written consent of the other. 11.5 Notices. All notices which may be required under this Contract are to be in writing and delivered (a) to the attention of the party at the address listed on the signature page; or (b) bre email to the email address on the signature page; or (c) by fax to the fax number on the signature page, or (d) mailed by certified mail, postage prepaid, to the address listed on the signature page. All notices shall be deeme served upon delivery, successful transmission, or two (2) days following deposit of the notice in the U.S. mail as required herein. 11.6 Governi Law, Venue. The performance and interpretation of this Contract shall be governed in accordanec with the laws of the State of Massachusetts. Any litigation arising out of or in connection with t1 is Contract shall be conducted in the County where work isperformed. CONTRACTOR: OWNER: X31 BY:------ __- .. .� By: ` ----- d l'ri rated Nanle: � � ��k Printed ame: r `t��:[ _ t�_ i�� Title:- �.., )r�.� Title: kA f -- - E-Mail: Cn . Aj'zw :66 ,-2o�1 1 -Mail:.�_.v _ — �.� I'aX: Fax: _. Address: t ° �, Address: _T1•SCk .w � f�r _—__-. Contractor License No. _ Exhibits, A Plat s B ---Esti hated Project Cost dated _ C-1 — U lconditional Lien Release Form C-2 -- C nditional Lien Release On Final Payment Form D -- Change Order EXHIBIT A PLANS List of Plans provided by Owner: 4 . J. 4. EXHIBIT B ESTIMATED PROJECT COST (To be provided by Contractor) i EXHIBIT C-1 CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT I'lle undersigned has been paid and has received a progress payment in the smin of$. R For labor, services, equipment, or material furnished to the job of (Maker at'Checl;) x located -- at ------_.___. -- (Owner) flop Description) and when the check has been properly endorsed and has been paid by the bank upon which it is drawn, the undersigned does hereby release any mechanic's lien, stop notice, or bond right that the uncle€•signed has oil the above reforer cod job to the following extent. This release covers a progress payment for labor. services. egLdptllent, or €taterials furnished to only and does not cover ally retentions retained before or after the release date; extra,.; furnished before the release date for which ayment has not been received; or extras or items furnished after the release elate. Rights based upon wot•l pe€•fo€•nled or items furnished under a written change order which has been fully cxecuted by the parties )rior to the release date are covered by this release unless specifically reserved by the claimant in this re ease. This release of any mechanic's lien, stop notice, or bond right shall not otherwise affect the c ntract rights, including rights between parties to the contract based upon a rescission, abandonment, or breach of the contract, or the right of the undersigned to recover compensation for fern slled labor, services, equipment, or material covered by this release if that furnlslled labor. SeNiCe , egUipmellt, Or illatffilll was not compensated by the progresspayment. Dated: - - (Contractor) By (Print Name) EXHIBIT C-2 ONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT Upon receipt by the undersigned of a check from __—____ill the (Maker oPCheck) Sllnl of$_ __--payable___ payable to —all([ when the check (Payee) has been properly endorsed and has been paid by the bank upon which it is drawn, this document shal I become effective to release any mechanic's lied, stop notice, or bond right the undersigned has on €he,job of _located at __ -----.-- (pwter} (Job Description&-Address) "Phis release covers the final payment to undersigned for all labor, services, equipment, or material furnished oil the job. I3 Ifore ally recipient of this document relies on it, the party should verify evidence of paynleilt to the uncles signed. Dated: — {Contractor) By i Prim Name) i CHANGE ORDER I Number Date 2. Contractor Address Job Description 4. Property Address Dr Legal Description: 5. Contractor hereby agrees to make the change(s) specifiedbelow: See Attaclu-nent"A" 7. Previous Change )rders 8Reason for Change: See Attachment"A" ' ~ '-' -...— Extension: _ .~ ^.~.. Completion— '_ Attachment"A" Change Order No. a A — Initial Construction Control Document = W To be submitted with the building permit application by a M a Registered Design Professional for work per the 8"i edition of the waw"� Massachusetts State Building Code, 780 CMR, Section 107.6.2 r l l Project Title: 440 Great Pond Road Residence Date: January 31, 2017 t Property Address: 440 Great Pond Road Borth Andover MA Project: Check(x) one or both as applicable: New construction X Existing Construction Project description.: The project is to construct a single family residence at 440 Great Pond Road. The project was started in 2003 and progressed at differebt intervals The current owner is looking;to complete the interior of the existing framed building. The work will include electrical,plumbing HVAC and interior cabinetry and millwork. I Thomas F. Galvin MA Registration Number: 20285 Expiration date: August 31,2017 , am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: X Entire Project Architectural Structural Mechanical Fire Protection Electrical. Other: for the above named project and that such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 1.7, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to thet1� ` cj,l a `Final Construction Control Document'. Enter in the space to the right a"wet"or lw. G���� electronic signature and seal: '" t4o,202,85 e m0 c �� �� ..';t�t, r ,chltec , corr,a Phone number: )78-470-3675 d i Building Official Use Only Building Official Nance: Permit No.: Date: Note I.Indicate with an `x'project design plans,computations and specifications that you prepared or directly supervised. If`other'is chosen, � provide a description. The Commonwealth of Hassachra�e�s .Department of fndust°ial Accidexals a' 1 Cofigrea Street,SOS 100 'goston AIA 02114-2017 2017 w� www znass.govldia aucd And qqavits�nilders/CoxF�actoxsll Iectrzczansl� ers. d kexs Compe TDBEFffX WWffTEE� t�'CJ�O�t��7r ,leasep .t L 'bl ' lieant�fo�rruatzon C e(BusiessslOrganizaiionllvrJivic�uaJ}: Nam c�c7x�Ss: ; Cz Itatslzzp: Phon)#: .ed ' Type OfEPxo eject(rec q&OC' Are you az3.empXoyer?Cecl[tTie appropriate box: P audlar ar-timl).e 7. Q e 'cb steuotzon x,�Iaaemployexwith employees(Iuil 8. Remodalag 2,�I a snleproprietor or patfn phip andav=na employees�rozking£oxine in 9. D E7ol]tioII auy capanibr.IbTowoLkers'camp.insuz � � 10 E]Building additiIon 3.p I am.ahomeov�tez doing all wozkmyseI�jl�nvrorkers'comp.mstuancerequirecl_]! 4.Q I am alzomeovener audRill he hiring voutrac#ars to coz dual all m-1 onmY propea - 'WIU �.�_Ele c37 Te 1Ts or. a ddltia73s ens�Aefliat alt nor#raQ#ors eithexhavev�orkers'enznpensatiou insuranve oz are svie 72 FXum r g xepaixs ox additzons proprietorszuj:tltivo 5_ I am a general eontrac#p i and I�pve hired the sub-eanfrac#ors listed an tl�e attached s7zeet 13.[ Raofrepairs Kase sub-crnatzactA.stave smpi-yeas end bw workers'eomp.iusur �9 �Othev s,QWD are a cozpvrafinri and zts ofiiina hue ewe d'v Fheiz rig�it of�emp3ion perMGL c. 152,§1(4},and'we have na empldYees.LNavrkexs comp.z7asurance xequired xyapplicautthatcheakshox l mizsE also out doing all work auflthenhi£e outside conisaars mvust sahmit IirV a ew affi davi#mdicsting sanT i who sub rlayitind3e $ Y _ Co�trac#ors that cheoktlis tsax-ust a##acherlan ad[hhogal sh roasze?hezgz v1os'comp_palicnb rd sta#evrhefiher oznot#hvse e�#it es ave employees. J Yhasub-cnatrecinrshaveemployees,ihV"ftp o e�tlaatisprovidir�g-x�axxkers'co npensagorx irnsarancefor�rny er1zployees BeZa��tliepa�icy arzdjo�sits am an emp y irzfarmation. insurance Company Name: _ }c� 1 ,rz - NGG r. ExpirationDatej c_ U 11olioy#or delf-ins. li ins.Lia. CitylStatel�ip._ ys Job zteAddress: Y '� t odic numliex and e pixat�tox3 date). A.-Uad,a COT'o to orkexs' eoxnpensation 1?olzey declarationa3awinal o atiaxtpuuishalo by a flue up to$1,500.00 ailntre to sects e coverage as required undo-MGL c.x2,§25A xsWOF aadlox nate-ysa Imp lsonanen es veli as c vaZpenaltte e rweardedto Ofd a oofhive tiga�ns c)ftheDJA.�brl �ara'.c�a day against the vialatox.A cagy afthis statement may coverage-Vf)JjRGatiOp.- zdo riere certify U ev tfa pax T enaltas afpepju y tlaat the information providers iz Ove s true and correct. Si atatp: pfftciril r se only. Do rzotiv�'ite ire t7sis area,to he cornpleted by city or tarz offacial. I'armftCLicense# City or To-vn- IssnixtgAnihoxziy(chole 1)"e), j p ector I.$oaxcl of OxiLY t(circle Depazt7ne>at �.City/Towa Clerk �.Electrical lits ector �.�lnm��g ash 6.Othcw Phone# Corntaet I?'exson: ACp® DATE(MMIODNYYY) rz� CERTIFICATE OF LIABILITY INSURANCE 1/3/2017 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 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 NAM" acr Select Department Eastern Insurance Group LLC PHONE (800)333--7234 x66807 FAX No;(76s)5B6 8244 233 West Central Street E-MAILADDRESS,selectwork@easterninsurance.com INSURERS AFFORDING COVERAGE NAIL# Natick MA 01760 INSURER AArbella protection Ins. Co. 41360 INSURED INSURERs.Technolocry Insurance Co. 42376 DC Development & Construction LLC INSURERcAllmerica Financial Benefits 41840 c/o Stephen Doherty INSURER D: 100 Hale Street INSURER E: Haverhill MA 01830--3972 1 INSURER F: COVERAGES CERTIFICATE NUMBER-MASTER 16-17 REVISION NUMBER: 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. INSR ADDL S BR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMlDOIYYYY MMIDDWYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TTED IOD OOfl X COMMERCIAL GENERAL LIABILITY PREMISES Ea a urrenre $ r A CLAIMS-MADE OCCUR 8500060926 0/29/2016 0/29/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG S 2,000,000 X POLICY PRO- LOC AUTOMOBILE LIABILITY Ea accident5lNGLE LIMIT 11000,000 ANY AUTO BODILY INJURY(Per person) $ A ALL OWNEDSCHEDULED 1020001346 6/23/2016 6/23/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS X NON OWNED (Massachusetts) Pe PERTYt accident) $ HIRED AUTOS AUTOS Medleal payments $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIABCLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE N lA E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMB B IManda ory in NH)EXCLUDED? C3465254 /19/2016 /19/2017 E.L.DISEASE•EA EMPLOYEE $ 100 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500.Z.000 C Automobile WN9812931 1/1/2016 1/1/2017 Combined Single Limit $1,000,000 Scheduled/Hired/Non-Owned (New Hampshire) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apace Is required) EXCAVATION CONTRACTOR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North ,Andover 120 Main Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE John Koegel/PKG ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INSfk25nninnsi ni Tha ARnRn names anA Inn^ara ranieiarnrl marlrc of Aftnon I Office of Consumer Affairs and Business Re anon 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C,&�Exactor Registration Registration: 172892 ,' !1 Type: LLC Expiration: 8/8/2018 Tr# 419291 DC DEVELOPMENT & CONSTRUCT STEPHEN DOHERTY 100 HALE ST `~ HAVERHILL, MA 01830 ,�` '+� ~'� • Update Address and return card.Mark reason for change. SCA' :: 20nt-a5ri7 �— Address Renewal Employment Lost Card L%fre (Doorvrrir�rzccea,�,�y o�v�Labsac�icti,e�1 } _ Office of Consumer Affairs&Business Regulation License or registration valid for individual use only ll " HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registratiar#``':172892 Type: Office of Consumer.Affairs and Business Regulation iratCOE1 p Ex &A _ S/ a18 LLC f 0 Park Plaza-Suite 51.70 Boston,NU 02II6 DC DEVELOPMEI�TNST1CTfaN LLC STEPHEN 100 HALE ST HAVERHILL,MA 01836 udersecretary Not valid without signature Massachusetts Department of Public Safety Board of Building.Regulations and Standards License: CS-037817 C011SUrUCt4011 SL1laerVi30r L STEPHEN J DOHERTY i 100 HALE STREETill HAVERHILL MA 01830 Expiration:' Commissioner 10127/2017 I •1 1 s