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HomeMy WebLinkAboutBuilding Permit #555-13 - 120 WATER STREET 2/5/2013 Mr-6 eJ(Y TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: !' 011 4�J Zj Date Received Date Issued, ✓� IMPORTANT:Applicant must complete all items on this page ,p`a"'�,- MM ♦gyyy,,}.y �,� � $y�.",^"�.�.�: �'s �. r a?,=; �- � °'ray y�; �^ �r:•r� Y Y M!'{•T"2S�e"� �' f 2 T2F '� � -:�� 'C �. t 4 +�..r* ^9" �Y- y r C YT 1.PR®PERTNADWNER �-v�� f �� f 'w. ; c e..e�r-� .a�.-��,g-p.� i rpt O� -.��s ��s��M•y.e T "_, ��t F' MAPN®�' �EPARCELZOIVING DISjTRICT} _ Histone Distract , tno TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial, Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ++�. y `wz'�r �� ,..ti `=x• t '�-� ,�;: a ..`� �a; ;,� �; „ 7k•< .� :;�,tx x s e -�•t :»' 1 DSe tic ®Well , �� � <❑;Floodplain ®V1%etlands Watershed District #` .• g*.�- �„� a' „- -r�".e .s��. . AM Water/Sewer , �� 4 k DESCRIPTION OF WORK TO BE PERFORMED: V,M'(LFat2M � � t Qy►c�A-©�� �} (�u� �L� Identification Please Type or Print Clearly) OWNER: Name:s�?9 V( �'c'n�w a e Phone: Address: ur�r (�� (' V►'9 1(i L) st�wut ( - d Lf E►-� , �C®NTRACTORtNa e t �Ki�iv� � -- ' "_§ Phone:,�2=1 �t �' A s rvtr Add aksitli� +tiw lop Sp :tea yi-aa u pervisorsC=„onstruct onLicenser 4 . , EXp3,IDat_eA — a k1 4.`��.a��,< ARCHITECT/ENGINEER H N76 C- Phone: ct- 'l - 4-:-s z-- 0 U-►0 Address: 03 (fJ N(,r' q;x Q c�� Reg. No. L 0 0 ,F U . FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PERSF. Total Project Cost: $ q FEE: $ Check No.: Receipt No.: ., NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature.of Agent/Ovviigr Signature,of contractor Plans Submitted Plans Waived ❑ Certified Plot Man ❑ Stamped Plans �. i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 4 TYPE OF SEWERAGE DISPOSAL •� Public Sewer ElTanning/MassageBody Art E] Swimming Pools `E1 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 CONSERVATION Reviewed on Signature { COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decisionlreceipt submitted yes PEanning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature&Date Driveway Permit J J_� DPW TowY Engineer: Signature: Located 384 Osgood Street TI1.RE DEPARTMENT' - Temp Dumpster on site yes no Located at>124 Mairl`streetJ\. . . .. . Fire Dep �fi n$signature/claw .COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Dieter location, mast or service drop requires approval of Electrical Inspector Yes No DANCER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ® Notified for pickup - Date f Doc.Building Permit Revised 2010 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 o Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work o 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 ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/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 ❑ 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) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products MOTE: 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 subm;tted with the building application Doc: Doc.Building Permit Revised 2012 Location No.,�� /3 Date • • TOWN OF NORTH ANDOVER e Certificate of Occupancy $ Building/Frame Permit Fee $ / //Z-- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ q Check# 7 y 26139 f' Building Inspector E►2S E Location IZO J J �— Date 'T No. 9 r • TOWN OF NORTH ANDOVER Certificate of Occupancy $ � ' Building/Frame Permit Fee $ Foundation Permit Fee $ ` Other Permit Fee $ TOTAL $ Check# 12G 26336 Building Inspector ` . O o w CN°SE4 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 555-13 on 2/5/2013 Date: April 30, 2013 THIS CERTIFIES THAT THE BUILDING LOCATED ON 120 Water Street MAY BE OCCUPIED AS ERS Expansion - office space IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG NA Mills,LLC 17 Ivaloo Street Somerville,MA 02143 Building Inspec or Fee: $100.00 Receipt: 26336 Check : 1264 NORTH own o _ ., Andover . ' O No. 66 IL ;;N. Ah ver, Mass, V� C 0 C L.CAA I..C 1. S u BOARDOF HEALTH Food/Kitchen PERMIT. T LD Septic System THIS CERTIFIES THAT .. .. .c.�s...... &4.C ............................... BUILDING INSPECTOR ® Foundation has permission to erect ......................... buildings on .. ......( ! ��.. ......................................... hough ay to be occupied as ......../!�:.' .....�.......................... .vr.aw ....... ........... ..... �.��..... ,.... �!�. chimney . provided that the person accepting this permit shall in every respect conform to the terms oft a application Fin 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 INSPECTO UNLESS CONSTRUCTION STARTS Rough - - .................t00000000 Service..... . ........ .........................M1.. Final BUILDING INSPECTOR GAS INSPECTO� 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 1.1 4 GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns ,4_ -1.-0 FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain-pipe/stone/fabric filter/cover and outlet connection. FRAME:Fireblock-over girts/plates between floor joist Penetrations for plumbing, heat,elec,etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters-watch bearing at walls. Ridge&Hip-Provide proper connections. Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate. Stair stringers-watch cuts and heal support. Joist hangers-fully nailed w/hanger nails. Sill plates 2-2X6(1 PT)w/sill seal. Girts-solid brick or steel plate bearing at foundations %"air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beam s/LVL's,Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances-stairways, under beams Attic Access. (min. 22x30 w/3' headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior(not in soffit). Firecode S/R wood frame of"0"clearance fireplaces&stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8%of floor area. '/Z of required glazing shall be openable. Bedrooms required min.20x24 egress window or door. Vent attic spaces-"proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing-Smoke Chamber-Finish Smooth parging, clean joints, 8"solid @ combust. DECKS: Lag to house, provide flashing. Rails min. 36" high, Baluster max space 4"on center. Over 8'above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. - Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re-inspection fee- $30.00(Be Ready). Certificate of occupancy required prior to occupying structure. Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 92,455.00 m $ - $ 1,109.46 Plumbing Fee $ 138.68 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 138.68 Total fees collected $ 1,486.83 120 Water Street 555-13 on 2/5/2013 - Perform Office Build Out for ERS Expansion �x� r-.,, `ice--- �� E � � •P � � Stantec Architecture Inc. 303 Congress Street,6th Floor Boston MA 02210 Tel:(617)423-4252 Fax:(617)423-4333 Rantec April 30, 2013 File: Stantec Project Number 218410015 Mr. Gerald Brown Inspector of Buildings Town of North Andover 1600 Osgood Street North Andover, MA 01845 Reference: ERS Expansion Phase II East Mills, North Andover Dear Mr. Brown: The tenant fit out called ERS Expansion Phase II, located on High Street at East Mills in North Andover, MA, was to the best of my knowledge, belief,and understanding, constructed in conformance with the construction documents issued for building permit dated February 5, 2013, Permit# 555-13 in accordance with 780 CMR Commonwealth of Massachusetts building code. During the course of construction, representatives of our office made periodic visits to the site to observe the progress of the work. Respectfully, STANTEC ARCHITECTURE INC. linda.smiley@stantec.com 2013.04.30 09:03:23 -04'00' Linda Smiley, R.A. Senior Associate Tel: (978)270-3203 linda.smiley@stantec.com c. Kieran Whelan Dave Steinbergh Iss documend rl C OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER 4 0— CONSTRUCTION CONTROL 1. 8'SCM1ISt4 PROJECT NUMBER: 218410015 PROJECT TITLE: ERS Expansion Phase II PROJECT LOCATION: High Street, N. Andover NAME OF BUILDING: East Mills NATURE OF PROJECT: Corporate Fit Out IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I, Linda S. Shiley EGISTRATION NO. 1 Q0 8( BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ❑ ARCHITECTURAL ® STRUCTURAL ❑ MECHANICAL FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. 1 FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept,shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become,generally familiar with6the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 I SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINEN I /ER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, T AS TO THE SATISFACTORY COMPLET.i.ON AND R. I „ cTR OCCUPANCY. ,�`s D ;Et tii�4�ii!41 �ii ri9'1'�19�9 f�'•::�a�2;�r'J"Y!'�� SIGNATURE SUBSCRIBED AND SWORN TCS 8EF4R�cc � 'iC. 19 NOTARY PUBLIC MY COMMISSION EXPIRES ' ►+ oild e, ;;Ipp �t0b1¢�I�Et� / c i0n.ts�ch�re�"a�,1,i-i-,�.dne �� r.. •- M��aMMaseaE'�"�> oYo6� 1..3a. Q_ mt} ' miotloa � 6x�ron tk�0e��. t9 NORTH oven of 0% . - �.. , No. I t - h ver, Mass, .� COCMIC"I WICK �• S V BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT .. .. .C.C�... n7f-14 ..........��.....:. BUILDING INSPECTOR ��® V���.. � Foundation has permission to erect .......................... buildings on ..z, ............................................. Rough to be occupied as ........1�.�:'.''.' ..�°........................... .. .l � �.��..:.�..�'�: 0N. 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 ............................... Service. .............. ..... . .... i Final BUILDING 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 1 _ Standard Form of Agreement between Owner and RCG LLC where the basis of payment is the Cost of the Work Plus a Fee without a Guaranteed Maximum Price Date: January30��013Y R Owner: RGGNorth And �erN1i11sL C/b.'ARCG LLCS ., 17 31ualoo Street Sup a 101 Somer�►llle,MA 021 3 4 z' « , Contractor: & K Contra t�En 9 C , . `' .. . Architect: Project Name: ERSxpais�ion hash ��� � The Owner and Contractor agree to the terms stated by this contract. This contract supersedes any prior agreements, representations, or negotiations, oral or written. No liquidated damages shall apply to this agreement. This contract consists of the following documents: 1. Obligations of the Parties 2. Contract Sum 3. Project Schedule 4. Signatures Exhibits Exhibit A: Estimated Cost of Work Exhibit B: Project Schedule Exhibit C: Drawings Page 1 of 5 i 1. Obligations of the Parties Obligations of the Contractor: The Contractor accepts the relationship of trust and confidence established by this Agreement and covenants with the Owner to cooperate with the Architect and exercise the Contractor's skill and judgment in furthering the interests of the Owner; to furnish efficient business administration and supervision; to furnish at all times an adequate supply of workers and materials; and to perform the Work in an expeditious and economical manner consistent with the Owner's interests and in compliance with all applicable governmental codes and regulations. The Contractor shall keep full and detailed accounts and exercise such controls as may be necessary for proper financial management under this Contract. The Contractor shall keep full and detailed records of all books, records, permits, licenses, correspondence, receipts, instructions, data, and drawings associated with the Project including all Subcontractor contracts, invoices, vouchers, insurances, lien waivers, and other correspondence. The Owner and Owner's Accountants shall have access to review, audit, and copy all Contractor documentation. The Contractor shall retain these documents for a period of three years after final payment. The Contractor shall maintain insurance at the following levels with the Owner listed as a co- insured: Type of Insurance Limit of Liability Commerc alCe"Aa1-,Liaiit .r1,000,000 04 ,. r 16 Upon request, and at the cost of the Owner, the Contractor shall obtain a performance bond up to the total Cost of Work. Such costs shall be added to the Construction Volume. The Contractor understands that the Project will be financed by a construction lender and, then, by a permanent lender. The Owner may assign any of its rights under this Contract to the construction lender and the Contractor hereby consents to any such transfer provided no such assignment shall relieve the Owner of any of its obligations under this Contract, unless agreed to in writing by the Contractor. The Contractor shall execute any certificates, lien waivers, releases, receipts, and other documents as may be reasonably required by the construction lender or permanent lender including a subordination of its mechanic's lien rights to the construction lender's and permanent lender's mortgage or deed of trust. The construction lender for the Project will be: Obligations of the Owner: The Owner agrees to furnish or approve, in a timely manner, information required by the Contractor and to make payments to the Contractor in accordance with the requirements of this Agreement. Dispute Resolution: Claims, disputes or other matters in question between the parties to this Agreement shall be resolved by mediation or by arbitration. Prior to arbitration, the parties shall endeavor to reach settlement by mediation. Page 2 of 5 2. Contract Sum Cost of Work: The Contractor shall provide a detailed estimated Cost of Work to the Owner(see Exhibit A). The sum of these costs, including the fee is as shown below: Change Orders: The Contractor does not guarantee the Contract Sum in any form. In the event of changes to the Contract Sum, the Contractor will present written changes to the owner for costs that exceed the Contract Sum in the form of a Change Order. The Contractor will review all Subcontractor Change Orders before submittal to the Owner and Architect and make a recommendation for payment or non-payment. The Contractor's Fee will be calculated including anyapproved Change Orders. The Owner, Architect and Contractor will negotiate disputed Change Orders in good faith. Contractor's Fee: 10%of total construction volume. This includes pre-construction and project management services, and field personnel and associated management overhead. The fee is based on actual costs incurred, with final true up, and is billed monthly in arrears. Total Construction Volume excludes permits and fees, which shall be paid directly by the Owner. Construction management labor, standard tools and equipment, and labor-related overhead are covered within the fee. Specialty tools or equipment and any trade labor supplied by J&K personnel shall be charged separately. If a project is terminated or suspended by the Owner prior to completion, J&K shall be compensated for the actual cost of services provided prior to receipt of notice of termination or suspension from the Owner. Subcontractors: The Contractor plans to hire Subcontractors to perform the majority of construction associated with this project. The Contractor shall provide the Owner and Architect information on all of the bids received by Subcontractors and the names of the Subcontractors selected. Owner shall have the right to reject a proposed Subcontractor; however, in the event that this leads to a higher Cost of Work, the Owner shall pay for the difference. The Contractor reserves the right to reject any Subcontractor, even if it is the lowest bid, and to dismiss Subcontractors from the job that have been previously approved by the Owner. Payments: The Owner shall make progress payments on the Contract Sum according to the Requisition process described below. The Contractor shall, at the conclusion of each calendar month on the project,present to the Owner an application for payment(Requisition)for costs incurred during that month. The Requisition shall include all invoices, vouchers, partial releases of liens, expense reports, and any other evidence to support the validity of the Requisition amount. The Contractor may requisition for completed, but unpaid work based on an expectation of payment upon receipt of funds. The Owner, the Architect, or their representatives shall be afforded five(5) business days to review such application and question the Contractor about its contents. In the event there are no disputes, the Owner shall pay the Contractor within 10 business days of receipt of the Requisition. Payment by the Owner does not represent that the Owner or Architect have made a detailed examination of the documentation, inspection of the work, or verification of the accounting. Page 3 of 5 i 1 At the completion of the project, the Owner shall make a final payment to the Contractor based on a final Cost of Work with a truing up of fees. If further corrections to work are required that are not covered under warranties with Subcontractors, or that are not the outcome of negligence or poor workmanship by the Contractor; the Owner shall pay the Contractor for any work associated with performing the corrections based on the hourly rate agreed to in this contract. Retainage: The Owner shall not hold back any fees to the Contractor to ensure completion of the work. The Contractor will be expected to hold back fees from Subcontractors to ensure their performance based on the terms below: 1"1}x/0 of biifled ;,os s un ess fherwise�ap foxed b th'e¢'Ovii Termination of Contract: The Owner shall reserve the right to terminate or suspend the Contract at its sole discretion. Within 15 days of termination or suspension, the Contractor shall present an accounting of all its costs incurred for reimbursement by the Owner. If the Owner elects to proceed with the project without the Contractor, the Owner shall have the right to assume the Subcontracts and agreements related to the Project. 3. Project Schedule Date of Commencement: The Contract Time shall be measured from the date of commencement. The date of commencement of the Work shall be the date of this Agreement, unless a different date is stated below or provision is made for the date to be fixed in a notice to proceed issued by the Owner. Fe roa " f20 l3"4r suc00441hat=Notification oy roceecl iso yen b Ouun'er , .; , ' Contract Time: The Contractor shall provide to the Owner a Project Schedule (see Exhibit B). This Schedule is based on assumptions reached prior to the signing of this contract, which assumptions the Contractor shall attempt to clarify in the Schedule. However, the Schedule always assumes the Owner and the Architect respond promptly to requests for information and do not request any significant changes to the construction program. In the event that the Owner or Architect find any discrepancies with the Schedule or its Assumptions, they will promptly notify the Contractor, who shall make adjustments to the Schedule as necessary. According to the attached Schedule, the Contractor shall achieve Substantial Completion of the entire Work as follows: pae ofSutista tiaWAW letiono bendlater than-March 3;1, 8 .,201,3: :r': _. : The Contractor does not guarantee the date of completion. However, the Contractor shall not be entitled to additional fees based on delays in the project unless those delays can be shown to incur extra costs for the Contractor and were caused by the actions or requests of the Owner or Architect. The Contractor shall present an updated Project Schedule to the Owner and Architect on a weekly basis for their review. Page 4 of 5 I� e f 4. Signatures The Owner's representative is: ,3 . St inbe gh,Manager iFC�o h nd�ou'er M�l�s C 7�Ii�aloo�Str�eet,,S�uilte�Q, �_ mervle�M ►02143' § 14.4 The Contractor's representative is: Kie a Whelan J&KContractngL 3Ricmon Street �U;11.,eYmouth;MA 2188 This agreement is entered into as of the day and year first written above and is executed in at least three original copies, one for the Owner, one for the Contractor, and one for the Architect. Owner Co tractor 1. Si nature L Signature r'^ Printed Name and Title Printed Name and Title Page 5 of 5 • ERS Phase II Expansion 1/30/2013 Schedule of Values Estimated Cost General Conditions $ 4,000.00 Demolition $ 1,000.00 Frame walls and workstations $ 11,500.00 Drywall &tape $ 6,750.00 Prime and Paint $ 7,000.00 Doors &Windows $ 6,000.00 Carpet $ 10,000.00 Cabinetry & Countertops $ 1,000.00 Plumbing $ - Sprinkler Work $ 1,400.00 Electrical $ 10,000.00 HVAC $ 25,400.00 Sub-total $ 84,050.00 RCG Builders fee $ 8,405.00 Total $ 92,455.00 Plus Building Permit $ 1,116.00 iLss The Commonwealth of Massachusetts 02 Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 " www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLribly Name (Business/Organization/Individual):. � Address: KJNro City/State/Zip:_I�c YKa\1—% V-., ��t ik$e phone#: Are you an employer?Check the appropriate box: Type of project(required): LK I am a employer with 4. EJI am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. EJ New construction 2.El am a sole proprietor or partner- listed on the attached sheet. 1 7. 0 Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9, ❑Building addition [No workers' comp. insurance 5. El We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] 1 employees. [No workers' comp.insurance required.] 13.0 Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. P Homeowners who submit 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 an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site reformation. nsurance Company Name: L't a EYE-T y tivj UK9- 1 'olicy#or Self-ins.Lic.#: e-��, Z-- Expiration Date:�L_ �'\1 , ob Site Address: 2- W,Cc-!. k} 'N City/State/Zip: Lt- Mach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine 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 f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of lvestigations of the DIA for insurance coverage verification. do herebyce tify under the pains and penalties of perjury that the information provided above is true and correct i nature: /L_� Date hone#: Official use only. Do not write in this area,to be completed by city or town offcial. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 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 or 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 or 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 local licensing 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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(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 sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of r 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 perinit/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 would like to thank you in advance for 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 Industrial Accidents Office of Investigations - 600 Washington Street Boston,MA 02111 Tel. # 61.7-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia M,lssachijsettti�Departmc►r..t of Public S lfety Board of Building; Regulations and Stan(I;u•ds Construction Supervisor License License: CS 66334 NZ a� KIERAN T WHELANftg 31 RICHMOND ST WEYMOUTH; MA:02188 1 Expiration: 9/26/2013 e ('omiyiis9ioneu. Tr#: 6168