The URL can be used to link to this page

Home My WebLink AboutBuilding Permit #487-2017 - 12 ALCOTT WAY 5/1/2018 scPwW60 AAJUp G � �` TOWN OF NORTH ANDOVER oRr N N APPLICATION FOR PLAN EXAMINATION Of�t�au b�q F A Permit NO: ;L0 7 Date Received 1 F a 4SS^CNUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page (� LOCATION r.2 �Cc' 1 WC-y Print PROPERTY OWNER 6 d CA d M a UT-e-M Cc I Print MAP NO.: a� PARCEL: d 114 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building (One family ❑Addition ❑Two or more family ❑Industrial Alteration No,of units: ❑Repair,replacement ❑Assessory Bldg ❑Commercial Demolition ❑Moving relocation ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED / t -C ac t h 4vtC✓ p� VL 0A e —[tel- (q ,,T—'/7 C Identification Please TypeorPrint Clearly) OWNER: Name: 6 1'(( c,"'cf a urM A ��1 (,A J Phone: Address: I2 At CcN- dAlYou- c7�(/a CONTRACTOR Name:—(;-- Arc) Cc--,, r0/c�u'1� h C• Phone: �7 7�" 313 `2 3 6 2 Address: c� r" F47 ger— Q4 , (-kw''erf(( Ulf!G4 a 3G Supervisor's Construction License: "73 94 T Exp. Date: -5,/C(f. 4 Home Improvement License: /5-6 7-W Exp. Date: S' 6 /( 7 ARCHITECTIENGINEER Name:Phone: Address: Reg.No. FEE SCHEDULE:BULDING PERMIT.-$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost:$ 3 , T/0 x12.00=FEE:$ Check No.: 10 S 7 I Receipt No.: 3/1 Page lof4 t OORTH BUILDING PERMIT 0 TOWN OF NORTH ANDOVER 02 APPLICATION FOR PLAN EXAMINATION '� Permit No#: Date Received \V DRRTED,pP 9SSACHL]SEC Date Issued: MORTANT:Applicant must complete all items on this page ....-,�.:<.. ""'?."�'.��,+ .-.-rssS' ,t•��--q..--.d,_,.,,.�.-.�-�.x-.-^�'TMf y ✓"_-.2.. -y _ ��-�.q_.. __ — —_ =T {,(y._-d LOCATION, (PRO_PERItY{®V11NER ��ZPnnt � '�10D�Year;S�trueture V dye's�- no 4MAP: IPARCEL ZONINGiDISTR1CT a '�? r-�'.�Histonc ®istfict' ayes tno; TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic •0 Well ❑Floodplain D Wetlands 0 Watershed Distnat r R D Water/Sewer _ _ _ Z _ _ I • J DESCRIPTION OF WORK TO BE PERFORMED: t Identification- Please Type or Print Clearly OWNER: Name: Phone: h Address: Contfactor Name: Phone:. . _ AddZ4. _ r. ^.w- sr= �-.r' �' N ' -_•. ,' -` +.s""�..�c a"Y'*",v. ""`_^"::sa ....,...� +ty nom- 'i,. .. I C. Superyisors►Construct&lLicense _t _Ex Date:, -.- - • z. 3 - - y .{• — ..r_ .. r— Home Irnpovement License _ _ .r tExp, Datei ._; ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $ Check No.: Receipt No., NOTE: Persons contracting with unregistered contractors do not have.access to the guaranty fund 5irgna+uie of.Agent/Owner Signature of contractor Location f . c-o 4 No. Y F-1 - 9.01 7 ` Date //. - Po i . •+ TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 0 S I � I J `1 1 5 v Building Inspector TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ Tanning/Massage/Body Art ❑ Public Sewer Tobacco Sales ❑ Food Packaging/Sales ❑ Well ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. ❑ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor 4� Xj",- Plans Submitted Plans Waived ❑ Certified.Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING&DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS + Zoning Board of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection/Signature&Date Driveway Permit Temp Dumpster on site yes—no— Fire Department signature/date i I t �- , Plans Submitted ❑ Plans Waived E Certified Plot Plan ❑ Stamped Plans ❑ F WERAGE DISPOSAL ❑ Tanning/MassageBody Art ❑ Swimming Pools❑ 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS r -- CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT _Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date CO !MENTS `� limension 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 dropYrequires approval of Electrical Inspector Yes No ®ANGER ZONE LITERATURE: lies No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine -NOTES and DATA— (For department use) ❑ Notified for pickup Call Email ate Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. r 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 ❑ Building Permit Application ❑ Certified Surveyed Plot Plan a Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ 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 a Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 40TE: 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:Building Permit Revised 2014 - I Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 39,910.00 m $ - $ 478.92 Plumbing Fee $ 59.87 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 59.87 Total fees collected $ 698.-65- 12 Alcott Way interior remodel 487-2017 on 11/8/2016 NORTH Town of ndover 0 1 - 1h ver, Mass, H ' g i 4 COC NICNl WICK 1 U BOARD OF HEALTH Food/Kitchen PERMIT . T LD Septic System THIS CERTIFIES THAT .......&.!.... f ....k......&"9 4.f..............................�.�.�,.�!�.a�......... BUILDING INSPECTOR has permission to erect .......................... buildings on ...... . .�. ....W.041.............. Foundation p ........RIE&.00ACAL...... ....... r!..................................... �.................................................. Rough y t0 be occupied as 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 CONSTRUCTI ST T Rough Service .... . .. . .................... BUILDING. . . . INSPECTOR.. Final 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. G, Profft Constructon, Rnc- 38 Whittier St. Haverhill, MA 01830 978-373-2302 Agreement between Client and Contractor. Client information:Bill and Maureen Collins 12 Alcot Way N.Andover,MA 01845 Contractor information: G.Profit Construction,Inc. Gurney Profit 38 Whittier St. Haverhill,MA 01830 978-373-2302 Federal Employer ID#20-3892904 Home Improvement Contractor registration# 156781-8/06/17 • Construction Supervisor's license#73895-3/06/18 Agreement date: 10/24/16. Proposed start and completion schedule.The following will be adhered to unless circumstances beyond the contractor's control arises. Start date: 10/31/16. Finish date. 12/2/16(when contracted work will be substantially completed). The following building permits are required and will be secured by the contractor: Building,electrical and plumbing. Total contract sum: $39,910.00.The contractor agrees to perform the work,furnish the materials and labor as specified on the scope of work page except where noted. Any alteration or deviation from the specifications involving extra costs will be executed only upon written orders. The change order will become an extra charge over and above the contract. All change orders must be in writing and signed by both Bill and Maureen collins and G.Profit Construction,Inc.The change order will be charged an hourly rate of $125.00 plus any additional materials. The cost of the change order will be due upon completion of the change order. �I Building and Remodeling Commercial and Residential t G. Profit Constirucdon, Rnc. 38 Whittier St. Haverhill, MA 01830 978-373-2302 The contractor's labor warranty is 1 year after the completion date.Subject to normal use. Manufacturer's warranty where applicable. There is no warranty on products not provided by the contractor. The contractor is not responsible for materials that are reused. The contractor is not responsible for unforeseen issues uncovered during the remodeling process. The contractor will remove all of his construction debris from the site and adequately keep the property safe and clean.All work shall be completed in a professional manner and in compliance with all building codes and applicable laws.The contractor shall adequately protect the work,adjacent property and the public. The contractor agrees to be solely responsible for the completion of the work described regardless of the actions of any 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 agreement. Payments will be made according to the following schedule: $13,000.00 first day of the project. $8,000.00 upon completion of the framing,insulation and rough electrical. $4,000.00 upon completion of the blue board and the plaster. $4,000.00 upon completion of the flooring. $4,000.00 upon completion of the finish carpentry. $4,000.00 upon completion of the painting. $2,910.00 upon completion of the contract. Building and Remodeling Commercial and Residential Go I raflt Const °ucdon, enc. 38 Whittier St. Haverhill, ISA 01830 978-373-2302 ' ll The scope of the project is as follows: Project prep. Install plastic sheeting around the work areas to control the dust during the project. Demo. Remove the interior trim from the patio door and the transom window. Remove the baseboard in the family room,kitchen,master bedroom,master bathroom and the quest bathroom. Remove the toe kicks from the kitchen cabinets and the master bedroom cabinets. Remove the crown in the dining room,front hall and the second floor hall. Remove the fireplace. Remove the drywall on the back wall of the family room,the ceiling above the family room,the fireplace chimney enclosure,knee wall at the end of the second floor hall and as necessary to construct the floor of the new room. Remove the insulation from the back wall of the family room and the ceiling. Remove the framing of the chimney enclosure and the knee wall at the end of the second floor hall. Remove the hardwood floor in the family room,the tile floors in the kitchen,master bathroom and the quest bath and the carpeting in the master bedroom. Framing. Construct a floor using 2 x 10 lumber for the floor joists and'/a"Advantech plywood for the subfloor that extends from the second floor hall to the exterior wall of the family room. Construct two closets in the new room. Install I x 3 strapping on the new ceiling in the family room. Enlarge the opening leading to the master bathroom. Install joist hangers on all of the joist ends. Electrical. Remove the ceiling fan in the new room and install it in the quest bedroom. Lighting-install six 6"recessed lights in the new ceiling of the family room,three 6"recessed lights in the new room, six 6"recessed lights in the master bedroom and two 6"recessed lights in the master baihroom. Building and Remodeling Commercial and Residential , ProM Construcon, Recd 38 Whittier St. Haverhill, IIIA 01830 978-373-2302 Provide outlets along the walls of the new room. Relocate the switches and outlet in the knee wall of the second floor hall. Provide and install an exhaust fan in the master bathroom and the quest bath and connect to the existing ductwork. Provide an outlet and cable for the TV in the family room. Provide electrical connections for the new appliances. HVAC. Relocate the supply ductwork in the hall. Plumbing. Install a sink,faucet and toilet in the guest bathroom and the master bathroom. Rework the drain under the kitchen sink. Provide plumbing connections for the new appliances. Insulation. Insulate the bays of the open portion of the back wall of the family room and the open portion of the ceiling of the new room with spray foam insulation. Wall and ceiling finish. Install %"blue board on the back wall of the family room,ceiling of the new room and the two new closets. Patch all walls and ceilings that were disturbed to access plumbing,electrical.HVAC and framing. Apply a plaster finish to all of the new blue board and patched areas and blend into the existing finishes. Flooring. Install hardwood flooring in the kitchen,family room,new room,master bedroom and master closet. Sand and finish all new hardwood as well as the flooring in the second floor hall. Building and Remodeling Commercial and Residential G. Proflt Construct on, Rnco 38 Whittier St. Haverhill, MA 01830 978-373-2302 Install cement board over the existing subfloors of the guest bathroom and master bathroom.The cement board will be installed over a layer of thinset mortar and screwed down. Install a ceramic tile floor and grout the tile. Finish carpentry. Install a door on each new closet Install trim around the patio door and the transom. Install a vanity in the quest bathroom. Install baseboard in the kitchen,family room,new room,master bedroom,master closet,master bathroom and the quest bathroom. Install crown moulding in the dining room,family room,first floor hall and the second floor hall, Re-install the toe kicks in the kitchen and master bedroom. Enclose the pole under the peninsula with pine trim boards and baseboard. Install open wire shelving in the two new closets. Install a TV on the wall. Install the new kitchen appliances. Painting. Paint the walls,ceiling and trim of the dining room,family room,front hall,second floor hall,new room,master bedroom and the quest bedroom. Paint the baseboard in the kitchen,master bathroom,master closet and the quest bathroom. Paint the support column under the peninsula. Stain the two handrails on the stairs. As discussed the following items will be provided by the homeowner-wood flooring for the kitchen and the master bedroom,crown moulding,appliances,cabinetry,plumbing fixtures and countertops. If the kitchen requires a new subfloor,it will be at an additional cost to the estimate given. Building and Remodeling Commercial and Residential i J Ga Profit Construction, Rnc. 38 Whittier St. Haverhill, MA 01830 978-373-2302 Upon signing,this document becomes a binding contract under law. You may cancel this agreement provided you notify the contractor in writing at his main office no later than midnight of the third business day following the signing of this agreement. Do not sign this contract if there are a blank spacfs.. Client/lloeow Date o 24 Contractor.. _� "G41f' Date l0, 2 C I look forward to working with you on this project. Since ely, Gurney Profit j Building and Remodeling Commercial and Residential Ga Proffk (Construction, Race 38 Whittier St. Haverhill, MA 01830 978-373-2302 The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration(as an alternative to court action)if they have a dispute with a contractor.The same right is not automatically afforded to the contractor,however.The contractor will have to resolve any dispute he 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 the homeowner by the Home Improvement Law. The contractor and homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract,the contractor may submit this dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided in Massachusetts General Laws,chapter 142A. Client/Homeown r '� `' Contractor —,e- 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 the parties do not separately sign this section. A homeowner's rights under the Home Improvement 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 Fund 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 a warranty for workmanship or materials. In addition to guarantees and warranties provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular purpose.An enumeration 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 consumers rights.If you have questions about your consumers/homeowners rights contact the Consumer Information Hot line listed below. Building and Remodeling Commercial and Residential G. Profit Construction, Rnc. 38 Whittier St. Haverhill, MA 01830 978-373-2302 The contract must be executed in duplicate and should not be signed until all 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 contract with attachments is to be given to the owner and the other to be kept by the contractor.Any modification to the original contract must be in writing and agreed 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. A contractor may not demand payments in advance of the dates specified on the payment schedule in cases where the homeowner deems himself/herself financially insecure. However,in instances where a contractor deems himself to be financially insecure,the contractor may require that the balance of the funds not yet due to be placed in a joint escrow account as a prerequisite to continuing the contracted work.Withdrawal of funds from said account would require the signatures of both parties. 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 Guide to Home Improvement"contact: Consumer Affairs 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 http://www.mass.gov/ocabr/ If you want to verify the registration of a contractor or if you have questions or need additional information specifically about the contractor registration 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 http://www.mass.gov/ocabr/ Building and Remodeling Commercial and Residential Go PIr®flt Construction, Inco � 38 Whittier St. Haverhill, MA 01830 978-373-2302 Go online to view the status of a Home Improvement Contractor Registration: httu•/!db state ma uslhomeimprovement/licenseelist.asn. For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the Attorney General 617-727-8400 and/or Better Business Bureau 508-652-4800,508-755-2548,413-734-3114 Building and Remodeling Commercial and Residential `� �� ----� i E �_� - — / } �J �� -�D� �V e��y� t 2 � JL J L JL „ J �- Lal) � �✓ZLti�,�U• ��-.4 PARKING LICENSE AGREEMENT This Parking License Agreement(this"Agreement") is made, dated and effective as of _,201 ,by and among EDGEWOOD RETIREMENT COMMUNITY,INC., a Massachusetts not-for-profit corporation having an address of 575 Osgood Street, North Andover, Massachusetts ("Edgewood") and THE TOWN OF NORTH ANDOVER, a body politic, having an address of 120 Main Street, North Andover, Massachusetts 01845 (the "Town"). WITNESSETH: WHEREAS, Edgewood is the owner of certain parcels of land commonly known as 575 Osgood Street, which are located in the Town of North Andover, Commonwealth of Massachusetts, and legally described on Exhibit A attached hereto and incorporated herein by reference(the"Edgewood Property"); and WHEREAS, the Town desires to obtain a license for the use of five (5) parking spaces located on the Edgewood Property and more particularly depicted on the plan attached hereto as Exhibit A and incorporated herein by reference(the "Designated Half Mile Hill Spaces"); and WHEREAS, Edgewood is willing to grant such a license to the Town, specifically to permit members of the public desiring access Half Mile Hill ("Authorized Parkers") the use of parking spaces in connection with such access to Half Mile Hill, all on the terms and conditions set forth herein; and NOW THEREFORE, in consideration of the promises, the covenants contained herein, and for good and valuable consideration, the sufficiency and receipt of which are hereby acknowledged,the parties do hereby agree as follows: 1. Recitals. The foregoing recitals are incorporated herein and made a part hereof. 2. Grant of License, Relocation. Edgewood hereby grants to the Town, the perpetual right, privilege and license to park passenger automobiles, but specifically excluding, however, trucks, commercial vehicles and campers in excess of one ton capacity or possessing more than four (4) wheels (each, an "Automobile"), in the Designated Half Mile Hill Spaces for the use by the public in connection with the use of Half Mile Hill, all in accordance with all of the provisions of this Agreement (the "Parking Rights"). The parties covenant and agree that throughout the term of this Agreement, Edgewood shall have the right, from time to time, in its sole and absolute discretion, to relocate the Designated Half Mile Hill Spaces within the Edgewood Property upon written notice to the Town. 3. License Fee. There shall be no fee charged for the Town's proper exercise of its Parking Rights pursuant to the provisions of this Agreement. The Town's sole right under this Agreement is to allow Authorized Parkers to park Automobiles in the Designated Half Mile Hill Spaces, in accordance with the provisions of this Agreement. No other rights are granted. -1- 56189099 v 4. Repair and Maintenance. Edgewood shall perform maintenance,upkeep,repairs, and replacements to the Designated Half Mile Hill Spaces as necessary to maintain the Designated Half Mile Hill Spaces reasonably free of debris,snow and ice at all times. 5. Liability of the Parties. Pursuant to M.G.L. c.21, s. 17c,neither Edgewood nor the Town is liable to any member of the public for injuries to persons or property sustained by such person while on the Edgewood Property in the absence of willful,wanton or reckless conduct. The Town agrees that Edgewood shall not be responsible or liable to the Town, or to those claiming by,through or under the Town, for any loss or damage that may be occasioned by or through the acts or omissions of persons parking in the Designated Half Mile Hill Spaces, or for any loss or damage resulting to the Town to those claiming by,through or under the Town, or its or their property, for any casualty in the absence of willful, wanton or reckless conduct by Edgewood(its officers, directors,partners, shareholders, managers,members and employees); it being understood that Town shall always look to its own insurance for any damage or claims which it may have relating to damages or claims from injury to persons or property. Accordingly,the Town hereby releases Edgewood(together with its officers,directors,partners, shareholders,managers,members and employees) from any and all claims which arise from or are in connection with the Parking Rights granted herein. 6. Notices. All notices shall be in writing and mailed certified mail,return receipt requested to the addresses set forth above or to such other address as any party may designate by written notice to all other parties. 7. Additional Provisions. Invalidation of any one or more of the provisions of this Agreement by judgment or court order shall in no way affect any other provision hereof, each of which shall remain in full force and effect. 8. Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the Commonwealth of Massachusetts. 9. Subordination. This Agreement and all of the rights of the Town hereunder are and shall be subordinate to the lien of any mortgage which may now or hereafter affect the Edgewood Property, and to all renewals,modifications, consolidations, replacements and extensions thereof and to any and all advances now or hereafter made thereunder. This subordination shall be self-operative and no further instrument of subordination shall be required to effectuate such subordination. However, in confirmation of such subordination, within ten(10) days following Edgewood's request,the Town shall execute and deliver any certificate or document in recordable form that Edgewood may request evidencing such subordination. 10.Estoppel Certificates. The Town agrees, at any time and from time to time as requested by Edgewood, upon not less than ten(10)days' prior notice,to execute and deliver to Edgewood a statement("Estoppel Certificate") certifying such information concerning this Agreement as Edgewood might reasonably request. -2- 56189099 v1 It is intended that any such Estoppel Certificate delivered pursuant hereto may be relied upon by others with whom Edgewood may be dealing. 11. Assignment. This Agreement and the Parking Rights granted hereunder shall not be assigned or sublet by the Town. Any such attempted assignment or subletting by the Town shall be null void and of no effect. 12.Limitation. This Agreement grants a license only, revocable or terminable under the terms and conditions herein, and does not grant any lease, easement or other interest in real estate. 13.Remedies on Default. If the Town fails to perform any of its obligations hereunder and such default shall continue for a period of 30 days following written notice of the same from Edgewood, then in such event, Edgewood shall have the right to terminate this License effective upon written notice of termination to the Town. Such termination by Edgewood shall be deemed effective on the date stated in such notice. Termination of this License by Edgewood as aforesaid shall not prejudice any other remedies which might be available to Edgewood under this License or at law or in equity. [SIGNATURES APPEAR ON FOLLOWING PAGE] -3- 56189099 v] Executed and delivered effective as of the date first above mentioned. EDGEWOOD: EDGEWOOD RETIREMENT COMMUNITY,INC. By: Name: Title: By: Name: Title: TOWN: TOWN OF NORTH ANDOVER By: Name: Title: -4- 56189099 v1 EXHIBIT A Edgewood Property (to be provided) -5- 56189099 vl -� 10/25/2016 5 : 17 : 30 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) (IM'PORTANT. 1iS,GEft7IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. IS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE R PRODUCER D THE CERTIFICATE HOLDER. 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 endorsement(s). PRODUCER CONTACT NAME: CHASE&LUNT,LLC PHONE FAX 65 PARKER STREET (Aro,No,Ext): (A/C,No). E-MAIL NEWBURYPORT,MA 01950 ADDRESS: 722MF INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: CONTINENTAL CASUALTY COMPANY G PROFIT CONSTRUCTION INC INSURER B: INSURER C: INSURER D: 38 WH[TTIER 5T INSURER E: HAVERHILL,MA 01830 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 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 I ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMlDD1YYYY) tMUDDtYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. DAMAGETORENTED $PREMISES(Ea occurrence) MED EXP(Any one person) $ GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 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 $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE Is DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND X WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-9806M018-16 06/02/2016 06/02/2017 LI ITS ANY PROPERITOR/PARTNER/EXECUTIVE N/A 100,000 OFPICER/MEMBER EXCLUDED? E.L EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF N.ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1600 OSGOOD ST BEFORE THFJEXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDE WITH THE POLICY PRO 2. a AUTHO R RESENTATIVE > N.ANDOVER,MA 018453 F, I:-; .� rY tSe ,. \CORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rig reserved. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print tir y-e y P✓'o k Location: 12 A l Cod- WO y CityN �I�o�vP�lWI/1 O/,'f-ff Phone ?7P -373 '2302. F-1 am a homeowner performing all work myself. F-1I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. on Company name: ! n (00S�_ruGh chr -lr`C Address 38 L4,; SV, �•1 f,' � t l(, A 0( J 3 0 Phone#: �7P 3-7_�- 2 3 G� Insurance Co. C 4//4 Policv# Company name: Address City Phone#: Insurance Co. Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify u er the pains and penalties of perjury that the information provided above is true and correct. / Signature Date I Ol Z 4lzr Print name G u,-,ie Phone# 27L ?-73-Z 302- Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's office Contact person: Phone A: ❑ Health Department ❑ Other FORM WORKMAN'S%OMPENSAWN Massachusetts Department of Public Safety Board of Suildi+►g Regulations and Standards License: CS-073895 Construction Supervisor GURNEY PROFIT � 38 WHITTIER STREET HAVERHILL MA 01830 t�=IZ;:;Z CA_ Expiration: Commissioner 03106/2018 License or registration valid for indlvldul use og '%/i iy :"' 1 before t:�e expiration date. If toured return 0. OIfee ofConsamerAffairs&nusiaessRegut�a Office of Consumer Affairs and Business Regulation ` __�fiOME IMPROVEMENT CONTRACTOR egistration: 156781 Ty 10 Mark Plaza-Suite 5170 �; Exp Boston,MA 02116 iration; 8/6/2017 Private Cc ='` J G-PROFIT CONSTRUCTION INC. GURNEY PROFIT �ithout 38 WHITTER ST ot v lid signature HAVERHILL,MA 01830 • �1j'aderseeserar