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Home My WebLink AboutBuilding Permit #036-13 - 102 HILLSIDE ROAD 5/1/2018 BUILDING PERMIT "°RT"qti TOWN OF NORTH ANDOVER o= 6 APPLICATION FOR PLAN EXAMINATION ey Permit NO: Q Date Received �•9 q�R17ED I•PP�.(� SSACHUS� Date Issued: —/z IMPORTANT:Applicant must complete all items on this page 14 rvfl t�--�-�t•.�,r,._>. '' �,�r x�nd.Fa/ - ,, aa�..a s+-�a-�.. ��. i PROPERT�Y0INNER��`(� �. y MAP�NO PARCELONINGDISTRICT hHistonciDistnct esu h x - . S N a .� �----� - h�-� opt =ex - _ M 1.sy'�.:� ...:, ,-, ..a.:.. ..x._w ;.s:�--. .:.,_'r�rts_ •.. :..�, .-..:. *m .A4,...#"�. .Z;�r' e',h yeS._... ac m h �Uillag± TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition LoOo�'" Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: I Demolition Other f _ �, c' i. t ,. .+: rcn a'"�-a-y'�t.' Se tic�g Well Floodplain}' F Vlletlands - WatershedDistrict ater/S DESCRIPTION OF WORK TO BE PREFOR30 D . Identification Please Type or Print Clearly) OWNER: Name:�d� tZ,J`''i C4'vdk Phone: Address: ��o� /�� S2,04� 44d J1116' �✓�� 71— � CONTIRA�CT;OR; Name G,J�t � J`'� zIg � ' `.horie _ " a�''S Ear -��.aar; � I Address 77777 rt 7 7"' .�-.i. K..,�ss, :-�a�.+..s "' .-r.F,r ..,ta^ c... + .-z.F'{-.--� { • Supervisor s Construcfion�Licensex (D%xc3 r ` _. 4 } _. 3 ip t � 4 .y*L� Home}Irn rovement1License .,/3,O�_77 : .w E=x Date ARCHITECT/ENGINEER lo�;W P�zP-'&r Phone: Address: Reg. No. II FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $__ ,coo FEE: $ Check No.: 0/72 Receipt No.: -�✓`�S—/� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund :t Si nature of _ .. x; 5ignature contractors3ofAgent/Owner I Plans Submitted Plans Waived Certified Plot Plan Stamped Plans ; i TYPE OF SEWERAGE DISPOSAL Swimming Pools ublic Sewer Tanning/Massage/Body Art Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS � 1 CONSERVATION Reviewed on Signature i 1 , COMMENTS HEALTH Reviewed on Signature I COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments I Water & Sewer Connection/Si nature&Date Driveway v Permit DPW Town Engineer: Signature: Located 384 Osgood Street ,.. a`" xS¢Conxsitec "` * 4. ^aa`7`kae``T•,. ',,r a; 'v'' t'v.. "`L"`" 'E7' a. FIREDEPARyTMENT� TempDumpster; �yes �n.oti . �. x n,< Locatedat12'4 MainS" eet `� � = xh gr ,., dyf' S,fy'"" °' '`tb "T",.r FireDeparfinentsignature/d.�ated �� ; �> A �, ,. ; . °A �y �, Y s t > �r, F.ss�,�• z"t ` # xy .>'�'d.'� @ *� }7, '+.. +« ; 4-..�Jy�Q :="�''uvs •v.�� 3t' } �3 � iiP. ` II Dimension Number of Stories:_Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) i ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks qApplication Permit Ap lication Certified Surveyed Plot Plan �1Norkers Comp Affidavit �hoto Copy of H.I.C. And C.S.L. Licenses opy Of Contract Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And �-lydraulic Calculations (If Applicable) p( Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) y ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location r. No. W 3 Date fll Q h- Y_ t` a TOWN OF NORTH ANDOVER v Certificate of Occupancy $ `4Building/Frame Permit Fee $M6 Foundation Permit Fee $ 1 ` Other Permit Fee $ � TOTAL $ Check#16 /70 r 25513 �Building Inspector NORTH own of t sAndover o A - : � 0% No. 0 _ Y �O Lh " ver, Mass, � � �-- COCNICNlWtCK V s0'4ATIE � BOARD OF HEALTH Food/Kitchen PERM11T. T LD Septic System THIS CERTIFIES THAT � {..I.G,t / BUILDING INSPECTOR .... .. ... .... � �/ ,Q� �� Foundation has permission to erect .......................... buildings on ....... ...... ........ J............... ................................ Rough to be occupied as ............G .(.� 0!: ......�'�. ...... ...: ................................................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough j ............................... Service ..... ..... .GYM~ �`y"'... Final B�DILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Burner Street No. Smoke Det. SEE REVERSE SIDE ENERGY CONSE VAI10N APPLICATION FORM 1-FOg"C ENERGY &'tFF CY'r-NENCY FOP, ONE- AID `WO- AMILY DETACHED RESIDENTIAL CONSTRUCTION CmR 0_0(} Applicant Nanlm�� f" Sitc. Address: print �� --- Applicant Phone: Applicant Signature: - — — Bate of Application: NEW CONSTRUCTION: (goose ONE of the following two options) _ 780 CMR TABLE 6107.1 PRESCRIPTIVE.ENVELOPE COMPONENT CRITERIA FOR NEW ONE,AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Option 1: Slab Basement . Fenestration exposed Wall Floor Perimeter AFUE U-factor floors R-Value R-Value Wall R-Value IiSPF SEER R-Value R-Value and Depth National Appliance Energy 3 5 R-3 8 R-19 R-19 R-10 R-10' Conservation Act(NAECA)of 4 ft. 1987 as amended,minimums or greater as applicable Note: This form is not-required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2 REScheck—Web which can be accessed at http://www.energycodes.gov/rescheck/ ADDITIONS OR ALTERATIONS TO EXISTING BUILDINGS OVER 5 YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to detercitine the % of glazing: a Gross Wall �&CeilingArea equals Formula: 100 x b_a ( ) SF q ( ) f 100 x /X6 // S.3 %o of glazing (b) Glazing area equals—( — SF b a If glazin is<40% use the chart below. If glazing is>40 % proceed to"SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Fenestration Ceiling and Wall Floor . Basement Wall Slab Perimeter U-factor Exposed floors R-Value R-value R-Value R-Value l R-Value and Depth _ .39 R-37 a R-13 R-19 _ R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area i.e. not compressed over exterior walls,and including any access openings). ¢ SUNROOM—An addition or alteration to an existing building/dwelling unit where the total _ ❑ glazing area of said addition exceeds 40%of the combined gross wall and ceiling area of the � addition. j t Note. Owner to ill mut ��a� e Information For (found in Appendix 120. _— The Commonwealth of Massachusetts Depaihment of Industrial,Iccidents Office ofInvestigations ..600 Washington Street Boston, MA 02111 www mass go Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A__p121icant Information Please Print Le ibl • Name(Business/organization/individual)- : Business/Organization/Individual): 001, s - - Address: ..._._Z z- - — City/State/Zip; � /h .� /GI'iGtphone#: /�� 4 �cCr_ A710am u an employer?Check the appropriate boa: 1. a employer with 4. ❑ I am a general contractor and I r7. n roject(required):' employees(full and/orpart-timd). have hired the sub-contractors construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. odeling ship and have no employees These sub-:contractors have working for me in any capacity. , orkers' comp.insurance. g' Demolition [No workers'comp.insurance 5• Lf We are a corporation and its 9' Bui ding addition 3.Elrequired.] officers have exercised their I O•❑Electrical repairs or additions .I am a homeowner doing all work right of exemption per MGL 1 I.El Plumbing repairs or additions myself. [No workers'comp. c. 152,§I(4),and we have no insurance required.] t employdes. [No workers' 12.❑Roof repairs comp.insurance required.] 13.❑Other r-nY a??scan:that chew s bo.=. 1 m,--t also fill out thesecaon belot=.+sho:=W?�W� worm. C.__ aszdon T Homeowners who sPolicy information. ubmit this affidavit indicating they 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 sub-contractors and their workers'comp,policy information. am information.an employer that is providing workers'compensation insurance for my employees Below is the policy and job site Insurance Company Name: 41-3 Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address City/State/Zip j! ��. a 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 ofM.GL 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 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. Ido hereby certify under tl a pains and penalties ofperiuU that the information provided above is.true and correct Sip-nature: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person; Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express 6r implied,oral or written." An employer is defined as"'an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than-three apartments and who resides therein,or the occupant of the — _ ._-dwelling house-of another_who-employs.persons to do.maintenance,construction or-repair-work on-such dwelling-house-- .--- - ---. or on the grounds 6r building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,'§25C(6)also states that"every state or Iocal Iieensing•agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub=contractors)name(s),address(es) and phone number(s)along with their certificafe(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,.are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required Be-advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be wire to sign and date-the affidavit. The affidavit should aid ret L=�to the city or tt3Cti�i th a the Fy p uaE?Y far t'iE pe�F i or limns-1-be9_rg reop?ested,not the Depprt* ora.of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' - compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.. Please be sure to fill in the pemut/license number which will be-used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business.or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations wouldlike to thank you in advance f6r your cooperation and should you have any questions, please do not-hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of£ndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. 617-7274900 ext 406 or 1-8.77 MAS.SAF'E Revised 5-26-05 Fax#6.17-72.7-7749 j DATE(MM/DD/YYYY) -�CERTl.FICATE CIF:LIAB!-LI_T1(_INSURAN.CE T!,4S.CERTIFICATE IS ISSUED AS A MATTER:OF_INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR`NEGATIVELY AMEND,EXTEND OR 6LTER 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 and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements PRODUCER CONTACT NAME: DOHERTY INS AGENCY INC PHONE FAX (A/C,No Ext): PO BOX 1985 E-MAIL ADDRESS: PRODUCER ANDOVER,MA01810 CUSTOMER ID#: 22YMX INSURERS)AFFORDING COVERAGE NA1C# INSURED INSURER A: 'TRAVELERS INDEMNITY COMPANY INSURER B: TWOMEY&LEGARE CONTRACTING INC INSURER c: INSURER D: PO BOX 366 INSURER E: NORTH ANDOVER,MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER 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 WIINDICATED. _ __ --PERK. THE 7NSURANCE AfFF-ORDED BY THE POLICIES DE- MgEDWEREIN'IS SUBJECT TD-ALCTHE TERMS,EXCLUSIONS AND CONDITIONS OF'$OGH POLICIES-LIMITS skdWN MAY' - HAVE BEEN REDUCED BY PAID CLAIMS. INSR ..- - ADD SUB ` ., .POLICY EFF DATE. POLICY EXP.DATE - LTR TYPE OF INSURANCE .L- R POLICY NUMBER (MMIDD\YYYY)- (MMIDDWYYY) - LIMITS- GENERAL LIABILITYEACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE Q OCCUR. PREMISES(Ea occurrence) ED EXP(Any one person) $ PERSONAL&ADV INJURY $;: GEN'L AGGREGATE LIMIT APPLIES PER: ENERALAGGREGATE $ POLICY 'PROJECT❑LOC PRODUCTS_COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS. (Per person) HIRED AUTOS BODILY INJURY $ NONAWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB8 OCCUR EACHOCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ - - -- - _ WORKER'S COMPENSATION AND WeSTATUT`oRY urot OTHER - EMPLOYER'S LIABILITY YIN UB-029OM994-11 09/18/2011 09/18/2012 --' ANY PROPERITOR/PARTNER/EXECUTNE E:L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? Q E.L.DISEASE-EA EMPLOYEE $ 500,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO TTIE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. 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. AUTHORIZED REPRESENTATIVE - — -- - Charles J Clark ACORD 25(2009/09) 1988-2009 ACORD CORPORATION. All rights reserved. AUG-24-2011 WED 04:09 PM FAX N0. 9784750303 P. 05 j AC--ORD,,- Chen ;13298 CERTIFICATE OF LIABILI INSURgOMEYB DDucEa NCE DATE(MMrooyvY ryl herty Insurance Agency,Inc. THIS CERTIFICATE IS ISSUED q5 A MATTER OF INFORMATION 0.Box 1985 ONL06/24111 AND CONFERS NO RIGHTS UPON THE CERTIFICATE 21 Elm street HOL ER.THIS CERTIFICATE DOES Np►AMEND,EXTEND OR ALT R THE COVERAGE AFFORDED t3Y THE POLICIES BELOW. Idover,MA 01810 N UR90 INSUR RS AFFORDING COVERAGE Twomey Legere Contracting,Inc. INSURER : Ar8ella Protection Ins Com an NAIL PO Sox 366 INSURER : North Andover,MA 01845 INSURER ; INSURER C ERAGES WSURER : E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED kaoVE FOR THE POUCV PERIOD I Y REQUIREMENT.TERMOR AFFORDED OF ANY CONTRACT OR OTHER DOCUMENT WITH ESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR Y r ERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED NDICATED.NOTWITHST -DIGS.AGGREGATE LIMITS SHOWN MAY HEREIN IS SUBJE T TO ALL THE TERMS,EXCLUSION ENDING HAVE BEEN REDUCED BY PAID CLAIMS. LT Na YYPE Of INSURANCE S AND CONDITIONS OF SUCH POLICY NUMBEROTC E EC VE POA EXPIRATION A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 8500043255 O6/22J11 LINTS 06/22!12 EACH OCCURRENCE S1 OOO OOO CLAIMS MADE I x'OCCUR DAMAGE TO RENTED 5100 000 MED EXP IAny one person) $5000 PERSONAL I ADV INjuAy S1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- GENERAL AGGREGATE s2 000 000 JP T LUC PRODUCTS-COMP/OPAGG US2 OOO OOO ATOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT All OWNED aIrTOS (En accident) $ SCHEDULEDAUTOS BODILY INJURY HIRED AUTOS (Pet person) $ NON-OWNEO AUTOS BODILY INJURY (Per accident) S GARAGE LIABILITY PROPERTY OAMAGE (Per accident) S ANY AUTO AUTO ONLY-EA ACCIDENT g EXCE591UMBRELIA LIA81yTY OTHER THAN ZA ACC $ AUTO ONLY! OCCUR a CAGG $ LAIMS MADE EACH OCGURRkNCE S AGGREGATE $ DEDUCTIBLE RETENTION g S W1 RKERS COMPENSATION AND - $ E LOYFRS•LIABILITY S A PHOPHIETOR/PARTNEWExZCLrr,VE WC STATU. OTH. OF ICERIMEMBER EXCLUDED? S CIN•ROv�r E_L.EACH ACCIDENT $ ISIO 5 hekKw OT E.L.DISEASE-EA EMPLOYEE S ER E.L.DISEApE-POLICY LIMIT S DESCR Cove P NOF OPERATIONS/LOCATIONS f VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PRO ISION6 Coveri g operations usual to Twomey g Legare Contracting,Inc... i i CERTIFI ATE HOLDER CANCELLATI N Town of North Andover SHOULD ANY OFYI E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1600 Osgood Street OATS THEREOF, ISSUING.IIBURER WILL ENDEAVOR TO MAIL North Andover,MA 01845 NOTICE TO THE CE TiFlCATE HOLDER NAMED TO THE LEFT.aIITPAI—_URE TO DO 80 WRITTEN IMPOSE NO OBPQA TION OR LIA13ILlTV OF ANYSHALL REPRESENTATNEg KIND UPON THE IYSURFR,ITS AGENT9 OR AUTHORIZED REPR (YTATIVE ACORD 2 yzoolroal l of 2 #s27512/M27508 DML @ ACO CORPORATION 1988 la�s.aclau�ttts- Dep a►anent of Public Safety 4.•� Board of Building Regulation. and 5tandar(k °- Construction Supervisor License License: CS 55108 DOUGLAS J`LEGARE 79 GARY AVE HAVERHILL, MA 01830 " Expiration 912/2012 (;unuiuxsiiiiir Tr#: 2766 Alassachusttts-Department of Public Satfets Board of Building Regulationsand Standards F Construction Supervisor License License: CS 67560 SHAUN M TWOMEY' 61 PATROIT ST N ANDOVER,MA 01845 Expiration: 10/25(2013 F"uunmssi�>iirr Tr-#: 4913 711 airs �tBitsine�s"Ii�eg l"a�{i i HOME IMPROVEMENT CONTRACTOR ggyRegistration:. 136779 _ Type; =i :...Expiration: 8/26/2012 Partnership TMEY+LEGARE CONTRACTING INC, SHAWNTWOMEY 87 BELMQNT ST. g N:ANDOVER,MA 01845 Undersecretary 4, CONTRACTING INC . "Couldn't your home use a little TLC?" 87 Belmont Street, North Andover, MA 01845 HIC #136779 North Andover- 987.685.7447 Facsimile- 978.685.7446 CONTRACT 1. Date of Contract Signing: 2. List of Documents/Counterparts of this agreement: A. Contract B. Specifications/Proposal(See Exhibit B attached) C. Drawing/Plan(see Exhibit C attached) D. Payment Schedule(see Exhibit D attached) E. Limited Warranty(see Exhibit E attached) F. General Notes (See Exhibit F attached) 3. Parties to Contract: A. Contractor: Twomey&Legare Contracting, Inc. Shaun Twomey/Doug Legare Federal ID#20-3436110 Address: 87 Belmont Street,No. Andover,Ma 01845 Contractor Registration No.: 136779 B. Homeowner: John&Mary Ann Theriault 102 Hillside Road North Andover Ma, 01845 978-686-1.121 4. Description of work to be done and the materials to be used: See Specifications (Exhibit B) 5. Total amount agreed to be paid for work to be performed under the contract: 6. Time schedule of payment to be made under the contract, finance charges for late fees(if any)*: See Payment Schedule(Exhibit D) Owner Initials: Contract Contractor Initials: �Z Page 1 of 4 I *Any deposit required to be paid in advance of the start of the work shall not exceed one third of the total contract price or actual cost of any material or equipment of a specific or custom made nature,which must be ordered in advance of the start of the work to assure that the project will proceed on schedule. No final payment shall be demanded until the contract is completed to the satisfaction of all parties. 7. A. Date work is scheduled to begin: (see No. 14 below) B. Date work is scheduled to be substantially completed: (see No. 14 below) 8. Notice: A. All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor and/or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation 10 Park Plaza, Suite 5170 Boston, MA 02116 (617) 973-8700 B. For contractor's registration number, see first page. C. Homeowners have a three (3) day cancellation right under MGL Ch. 93 § 48; MGL Ch. 140D § 10; or MGL Ch. 255D § 14 as may be applicable. See attached Notice of Cancellation. D. For homeowner's warranty rights, see 780 CMR R6 and MGL Ch. 142A. 9. There is no lien or security interest on the residence as a consequence of this contract. 10. Permit Notice: A. The following permits will be required in connection with the work to be performed on your property: Building—,Electrical—Plumbing B. It is the obligation of the contractor to obtain these permits as the i Homeowner's agent. r Owner Initials: Contract Contractor Initials: f� �. Page 2 of 4 C. Any homeowner who secures their own construction-related permits or deals with unregistered contractors shall be excluded from access to the guarantee fund. 11. Contractor reserves the right, if he deems himself to be insecure,to require, as a prerequisite to continue work,that the balance of funds due under the terms of the contract, which are in possession of the owner,be placed in a joint escrow account requiring the signatures of the contractor and the homeowner, for withdrawal. 12. The parties agree that no work shall begin prior to the signing of the contract, transmittal to the owner a copy of the contract and the expiration of any applicable rescission period. 13. Arbitration Clause: The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract; the contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided in MGL Ch. 142A. 14. Other Provisions: A. Commencement and Completion of Work-Contractor agrees to proceed diligently with the agreed upon work, commencing promptly, following: • The completion of the Title V installation and certification of compliance by the town. • Issuance of a building permit by the town. B. Final payment shall be upon the satisfaction of the homeowner. The parties agree that the issuance of a certificate of occupancy and/or final inspection shall be the e objective standard that the contract has been complete and the par p satisfied. p Any final punch list items shall be reduced to writing,with an estimated date for completion. The parties agree that no escrow will be held for punch list items. C. Insurance–Contractor agrees to provide evidence of liability; workers compensation and other risk insurance. Owner agrees to provide copy of hazard insurance as is re ed by co tra or to coordinate policies. Owner Signature. Date: Z .— Owner Initials: � �~ Contract Contractor Initials: �J `4` � - Page 3 of 4 Owner Signature: Dater / Contractor Signature: Date: Contractor Signature: Date: Notice: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Owner Da Date Con ctor D?fe Contractor Date Owner Initials: Contract Contractor Initials: Page 4 of 4 - T WOMEY, LEGARE CONTRACTING INC . "Couldn't your home use a little TLC?" f — Specializing in residential additions 87 Belmont Street,North Andover, MA 01845 HIC #136779 North Andover - 987.685.7447 Facsimile- 978.685.7446 EXHIBIT D Job Total &Payment Schedule Payment No. Amount Due Date Received Remaining Balance JOB TOTAL $79.900.00 1 st on signing $10,000.00 On Signing $695900.00 2nd payment $10,000.00 Completion/Excavation $ 59,900.00 3rd payment $8,000.00 Completion of foundation $ 51,900.00 4th payment $20,000.00 Completion of roof $ 315900.00 5th payment $15,000.00 Completion of rough mechanicals $ 167900.00 6th payment $12,000.00 Completion of drywall $ 45900.00 7th payment $0 Completion ofpainting $ 4,900.00 8th payment $4,900.00 Completion of project based on $ - Specification page Thank you for considering TWOMEY&LEGARE CONTRACTING for your project. Please feel free to call with any questions or concerns. Homeowner Signature Date / Z Owner Initials- Page 6 of 11 Contractor Initials: e -711 -A LIM mL TWOMEY & LEGARE CONTRACTING INC . "Couldn't your home use a little TLC?" Specializing in residential additions 87 Belmont Street, North Andover, NLA, 01845 HIC #136779 North Andover- 987.685.7447 Facsimile- 978.685.7446 EXHIBIT B Proposal/Specification Homeowner: Contractor: Twomey& Legare Contracting, Inc. John&Mary Ann Theriault 87 Belmont Street 102 Hillside Road. North Andover, MA 01845 North Andover, MA 01845 (978) 685-7447 Second revision 7/2/12 Thank you for the opportunity to quote the following project. The Twomey&Legare Contracting, Inc.price is based on our discussion on June 20,2012 concerning your project at the above captioned address. The followingis a description of work to be completed leted as discussed: p 20 X 30 Addition,with frost wall foundation. New Master bedroom with full bath and walk-in closet. 1. Contractor to contact dig safe prior to digging. 2. Excavate as required for frost wall foundation. To include exterior perimeter drain. 3. Demo interior closet in spare bedroom,remove doorway and make opening larger. Remove exterior siding and 2 windows for new addition. Also cut foundation to basement. 4. Structure to be built according to plans provided by contractor in accordance with theses spec. 5. Owner to supply certified plot plan. Any additional as-built or plot plans by owner. 6. Fl oor'oist l � to pan. Walls to be 2 x 6 construction. 7. Floor sheathing to be 3/4 Advantec plywood. 8. Wall sheathing to be %2 CDX plywood,pine. 9. Roof sheathing to be 5/8 fir plywood. Owner Initials: Proposal/Specifications Contractor Initials: a Page 1 of 3 10. Roofing to be Certainteed TL,Architectural shingles with Ice and water shield up 3 feet from the eaves, and 3 each way in valleys. Limited life time warranty, 10 year sure start. 11. Siding on addition only, will be 4"over 4"Harvey clapboard siding. Build out window trim with 1 x 4 and wrap with aluminum coverage. Corners to be 3"vinyl outside corners. 12. Match existing trim boards and wrap. 13. Insulate addition to code. 14. Drywall to be '/z inch blue board plaster, with smooth walls and smooth ceilings. 15. Interior trim to match existing as close as possible. 16.All painting by owner. 17. No Exterior painting. 18. Disposal of all debris by contractor. 19. Additional spec, on completion of construction plans. 20. Any landscape or shrub replacement by owner. Contractor to spread existing loam to be racked and seeded by owner. 21.All permits and inspections by contractor. Sprinkler system-none A/C-none Heating 1. Extend existing heating zone into new wing, off left side of home on same zone. Owner states conversation with a plumber they had at home boiler will handle New addition.. Plumbing 1. Run new water and sewer lines for new bath and laundry in new addition. 2. Plumb for double sink. 3. Shower&toilet. 4. Washing machine, dryer is electric. 5. Installation of bath fixtures to be done at a later date. 6. All water lines to be copper pipes. Electrical 1. Add sub panel for new wing. 2. Wire addition to code. 3. Ceiling light,fixture by owner. 4. 2-closet lights by contractor. 5. 2-vanity lights by owner. 6. 1-phone 1-cable. 7.1-exterior plug. 8. Smoke detector in bedroom and new basement only. 9. Plugfor dryer. 10. Bath fan light combo. Fixture by contractor. 11. 1-Dimmer switch. 12. 4-recessed cans. Owner Initials: Proposal/Specifications Contractor Inti als: Page 2 of 3 i wl Windows 1. All windows supplied by owner. Interior doors �d 1. All interior doors. b /7 ) Exterior doors None. Flooring 1. All flooring and demo of old floor by owner. Tile 1. All tile by owner. Contractor Signature, Date: Homeowner Signature: Date: / 12— i Owner Initials: Proposal/Specifications Contractor Initials: Page 3 of 3