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Building Permit #68 - 21 HIGH STREET 7/23/2008
BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: L Y Date Received NORTF/ o�A.,Zeo s6g+ o p \� p�RArt O PPa ��y/ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition El Two or more family ❑Industrial e'AIteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other MR V � t l�`" at f� ."^a +g�{� {�2�;'"kl h' tij y G T { b eW DESCRIPTION OF WORK TO BE PREFORMED: 0 O Identification Please Type or Print Clearly) OWNER: Name: S)Vg,,1VO �'�'�� �`� Q Phone: Address: � v L ARCHITECT/ENGINEER w.A '"' 3C 64 �W`Phone: 4 ,-�`�`�`' �`� L'� Reg. No. Address: Z—' o L-N.�,- FEE SCHEDULE: BOLDING 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 too the guarantyfund Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ 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 PLANNING. &.-DEVELOPMENT COMMENTS CONSERVATION COMMENTS DATE REJECTED DATE APPROVED ❑ ❑ DATE REJECTED DATE APPROVED Q HEALTH ❑ COMMENTS DATE REJECTED DATE APPROVED A r Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/signature & Date Drivewav Permit Located at 384 Osgood Street 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 2 1 A —F and G min.$100-$1000 fine Doc.Building Permit Revised 2007 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 ❑ 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 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 2.2007 Location,)/ A� �`� No. 1 Date Z 3 G r MORTM TOWN OF NORTH ANDOVER Certificate of Occupancy $ —� '� s'•^° t��' Building/Frame Permit Fee $ ntNus .� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ��/'?�� 22241 Building Inspector Location No. G Date SORT►, TOWN OF NORTH ANDOVER • L Certificate of Occupancy $ IZ-q '�s •"'°''t�' Building/Frame Permit Fee $ swCHU Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 4y� oG3 22496 .1 ,' uiiding inspecto * Nom M 1 M � CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Permit # 68 (10/6/2009) Date: October 6, 2009 THIS CERTIFIES THAT THE BUILDING LOCATED ON 21 High SSt — Blda 3 F1 #1- Dowslake MAY BE OCCUPIED AS _ Office Suace ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG NA Mills LLC 21 High Street North Andover MA 01845 allBuilding Inspector cn m m m m mm 0 0 0 W C � CO) C7 10 0 CD CC Z y d0 �• r O CL y aCC2 0 0 CD CD� O Q d CD CD O CCD C CDCD CZ O CO) (M CD I C2 H O 10 Z CD O ...* o CD O CD O C y 0 C N = _d0 -O 1 H 0 m 00 n Z CO m CL �• = go M N �r►n LA. O• m ..r m y ._.0 y O �0 0 O O a ct > > 0 n -i to O Cc O N t7 Q7 O ►'� c �� �: N 11J 0 Q mE: m rr ^^ t0 O =r VJ � O N cnn mo o l J 0 am: n s Q 0 y o mGo: zHcr cnCL o N O ''^^ E � m N VJ N N V CT O C CD O\ 0 0 C*J z CD R 0 = o m cd m r: 0=m in so O �o hod - m �q z 0 y 0 c tz �- k "5,- .. \ d p r�-i r w 5 NN z 0 y 0 c m rol 1 W w o N x , U f� o cr Cc cc �u 0 LIJ U) UJ LLI -7 Cc CO cl cr 0 c) (D o uj I Lij co Z co U) Z .11 CO Li Lrl Lu :J) u- t -n P LJ t -L- f`lia.di. 90000 _ � - -� � RAr\aMOSY ACORD. CERTIFICATE OF LIABILITY INSURANCEo�o, ONW10 TYPE OF INSURANCE PRODUCER INSURANCE MARKETING AGENCIES THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 306 MAIN STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR WORCESTER, MA 01608 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. GENERAL LIABILITY 508 753-7233 INSURERS AFFORDING COVERAGE NAIC S INSURED RCG Builders LLC INSURER A: Associated Employers Insurance 21865 INSURER B: c/o RCG-LLC INSURER C. 17 Ivaloo Street, Suite 100 INSURERD: Somerville, MA 02143 INSURER E: rrnveewn_ee r nc rv""' Ur If4wKM(;t USTED 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER t�L�Y POLICY EXPIRATION Lam GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DAMAGETO RENTED $ ISEMED EXP (Arty one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ POLICY J CTPRO LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT 5 (Ea accident) ALL OWNED AUTOS SCHEDULED AUTOS (BPer per-ILY INJURY $ HIRED AUTOS AUTOS BODILNON-OWNED ((Perac )RY $ PROPERTY DAMAGE $ (P- acadent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCESSIUMBREU.A LIABILITY OCCUR D CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ i DEDUCTIBLE S A RETENTION $ WOR"RS COMPENSATION AND EMPLOYERS! LIABILITY WCC5005531012009 05/10/09 05110/10 5 X WC STATU 10TH - E.L. EACH ACCIDENT $500000 ` ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER(MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE$500 000 H yes dasaibe under SPECIAL PROVISIONS below OTHER E.L. DISEASE - POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEJMENT1 SPECIAL PROVISIONS ERTIFICATE HOLDER CANCELLATION For Informational Purposes SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL HWIDMVO§t TO MAR '10_ DAYS wronEN IIOTICE T'O THE I BMWATE HOLDER NAMED TO THHE LEFT, BUT FAILURE TO DO SO $HALL MWOSE NOOKWARON OR LIABILITY OF ANY MOND uPON Twomm3k nZ IGENfS OR rATNES AUTiID� t6HTATNE "I ` ii7 nmum -I aam i GCE 0 ACORD CORPORATION 1988 TOWN OF NORTH ANDOVER NORT/i Building Department ° 1600 Osgood Street Building 2- Suite 2-36 Building Dept North Andover MA 01845 9SSgCHUS � Tel: (978) 688-9545 Fax (978) 688-9542 COMPLAINT FOR INVESTIGATION DATE: ��� �/ T NAME OF COMPLAINTANT:�:-�- z ' ADDRESS.::... COMPLAINT TYPE: Electrical: Plumbing: -Gas: .,.-Building: 1 Property Owner: Address: / � � �-e-z J Other: Signed: villi" U Complaint Form - Revised 6.2007 F - RECEWLI) DANIEL LO'.t, TOWlf CLERK NORTI1 ArOOVER DEC 3 AM 18q t H� AMILY" :X a • i8ss • • '� SSAciiu9�',4 TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS NOTICE OF DECISION ' Any appeal shall be filed within (20) days after the date of filing of this Notice In the Office of the Town Clerk. Date .... N.oyember 26 , 1984 Petition No...... 5 7.- ` 8.4 ......... Date of Hearing .. N ox a m.b a r..19. , . 19 8 4 Petition of ..... N O.R. T H.. AND. Q Y ,R . M I LL. S ..R A.L T Y. , . L.I. P:1 IT E 0 ........................... Premises affected ..3 $ -.4 3. H i g.h . S.t r. e.e t ............................................... . Referring to the above petition for a v&if tido R m>th6 xoquitmeht afxthe . S.P. a c.i. a l .. P. e.r.m i t u.n.de.r.. Sect.i on..4.,..Pa.r.ag.r.ap.h ..4...11..( 3.).. o.f. t.he..Zon.i.n.I..By. .Law .............. --- so as to permit the .ex.te.ns ion.of an I -S zone.J.nto,an ?-,4. gne.,to,al,low. ' the _c.on.s.tr.uct.i.on. .of..a..one. .leve3..parkin.g..deck...... ........................ After a public hearing given on the above date, the Board of Appeah voted to .. G.r a PA ... the $.p e c.i. a 1.. P e.rm i .t .......... ....... and hereby authorize the Bu. ling Inspector to issue a permit to .. c o.n s t.r u c.t . t.h e. o n e..1 e.v. a 1.. p a.r k i .n g. A e c.k . w.i. t h i. n. Xh e.. R -.4.. z.o. n e... for the construction of the above work, based upon the following conditions: (see attached conditions) Signed F.ran.k . S.eri.o ,..Jr...., . C.hai.r.ma.n ........ W.i l IAam..J....Su.1. ; i.van................. ATTEST: A u g u.s t in a ..W ...N I ..k a r.s. o n............ A True Copy W a l ter ..F .. S o u.l. a .................... . Town Clerk Mauri ce..S....Fo.ul Is ................. Board 7f Appeals RECE{YED DANIEL LONG TOWN CLERK North Andover Mi 1 is Realty, Limited NORTH ANDOVER Petition No. 57-'84 November 26, 1984 DEC 3 10 39 AM '8q Conditipns of Approval for Special Permit: 1. That all lighting be down lighting. 2. That 1. the structure be restricted to no'more than a total of two (2) levels (ground level plus one). 3. That the remaining area in the R-4 district je open and green, suitably landscaped, not built upon, unpaved, and not parked upon. 4. That all conditions shall meet with other tows, Boards and -- agencies under Site Plan Review prior to the issuance of a building permit. 901 up Date/ . -.I.d .... TOWN OF NORTH ANDOVER PERMIT FOR WIRING 0 - This certifies that ... enh.AAI has permission to perform ... 1.17.1-1 )-ee . .. ............................. wiring in the building .. . ......... at ..4k. /-A.f f'-'2....5 '...........`...................... North Andover, Mass. ... . .. ....... CAL INSP Ecro Fee.�o . . ...... Lie. No... ........... . PLEMI Check# 19 oa I I SI-) IC', A m n t° b 5 CO2 11 n o ci y, cC o CD p� c� ami oa�ia oo� L• {� -1-+ Cl2 � L. A,- o C❑V G] tOj t10w'J O N "'y o a a7 O b. 90 04 m o A W m7 ❑ W b b c`� � .o ,o � m � ,� • a. c A g-4" �cyA 5� a bD m d •,p 0 ,hl t! o,b oiler N � i•L 4a O •d � {b�A O N y o •N y O •�+ � H U O �r .L~. w .. o '� 4-1 O n � A' GJ •V U N O y y c�.o.oaRto m,, o �� w cu h •g 11,9 C,4 W 0 o r+ .o •o y o � obO 0 U y 6Q Np U � cUR q a N O O w ¢+ y Nl.o��b -C9 vi orao� ob�a� m ba 0 U N 0 0 en N cd W O 3 ,o, g V V a I� r3 g boCq y �. m +., N n ao'i L •� m •n N OU Fol •M 6 QD 10 l.0/!i/IiUlf b!lMIlLiff Uff i'i2i��68Q.il6d�C'bi►? -- - -�a- ---' / Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank) M APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK rAll work to be performed in accordance with the Massachusetts Electrical Code MEC , 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Q t) City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 7_ ` h'\6 4 ✓� `� = ✓�� Owner or Tenant CA m P) & DG 6 w oey---- Telephone No. 54) < f y V-4 Owner's Address Zi�- Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 0(:-� L2— Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: r'mmnletinn nfthe fnllnwinv table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil:p• (Paddle) Sus Fans V _ ranso. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires AboveIn- Swimming Pool rnd. E]rnd. El o. o Emergency Lighting 1N Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches No. of Gas Burners Initiatin Devices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices Heat Pump Ner Tons KW No. of Self -Contained Disposers No. of Waste Dis P Totals: 'umb Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW p g Local ❑ Municipal ❑Other Connection No. of Dryers y Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW No. of ' No. of Data Wiring: Heaters Signs Ballasts No. of Devices or E uivalent Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or Equivalent OTHER: taL W' Attach additional detail zf desired, or as required by the Inspector of Cres. Estimated Value of Vle ical Work: (When required by municipal policy.) Work to Start: l0 (/ O Inspections to be requested in accordance with NEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in'force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains andp nalties ofperjury, that the information on this application is true and complete. FIRM NAME: 6VA-Z> flF ��Sl �l S �tC�Pn1 LIC. NO.: Licensee: Signature LIC. NO.: (If applicabl , enter "exempt" in the license number line.) U,3©Sus. Tel. No.: Address:: -7b 9-'r �3 f� 6\)\7-r- _C I�\LFt4� MA Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's Owner/Agent PERMIT FEE.-'$ Signature Telephone No. a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations w d 600 Washington Street Boston, MA 02111 ay ,.• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): C-\� �1�� —s`kS\g►kS i SyktuL -7`1 a 'J Address:4 l b City/State/Zip: `V kUG?'I� M \� 030S� Phone #: 1?60 a'Ot�P- 0 �O % x• 70 Are you an employer? Check the appropriate box: L ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2.r 1 am a sole proprietor or partner- listed on the attached sheet. $ ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] i employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. 8. P�Remodeling ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.0 Plumbing repairs or additions 12. ❑ Roof repairs 13. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. T 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. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lie. #: E), (� t_.k 3 A 3 i --( Z Expiration Date: Job Site Address: 0-1 1�k6W <�A_ City/State/Zip: U, ky>vicv__ AAA- Attach VI Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $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. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: 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): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #• f1, dcr Mnssacbusrtts Massachusetts Department of Conservation and Recreation Office of Water Resources Well Completion Report 19 -JAN -10 16:56:01 GPS North: 42° X6.873' GPS West: -710 12.948' Address: 121, VINE STREET Subdivision Name: City/Town: Lexington Assessors Map: Board of Health permit obtained: Y WELL LOCATION 269788 Property Owner/Client: NEXAMP INC. Mailing Address: 21 HIGH ST, SUITE 209 City/Town, State:N. ANDOVER MA Assessors Lot #: Permit Number:W220 Date Issued: 01/01/2010 Work Performed Proposed use Drilling Method Overburden Drilling Method Bedrock New Well Geothermal Open Loop Air Hammer Air Hammer CASING From (ft) To (ft) Type Thickness Diameter 2.00 -28.00 Steel 17# 6.00 SCREEN From (ft) To (ft) Type Slot Size Diameter WELL SEAL / From (ft) To (ft) WELL TEST DATA (AL) FILTER PACK / ABANDONMENT MATER CTI Material Descr L■J JAN �'5 201u TOWN OF NORTH ANDOVER MANDATORY FOR PRODUCTIOHEAL!DEPARTMENT Date Method Yield Time Pumped Pumping Level Time to Recover Recovery (GPM) (hrs & min) (Ft. BGS) (Hrs & Min) (Ft. BGS) 01/09/2010 Air Blow with Drill Stem 6.0000 000:15 600.0000 024:00 20 STATIC WATER LEVEL (ALL WELLS) PERMANENT PUMP (IF AVAILABLE) Date Depth Below Ground Pump Description: Measured Surface (ft) Type: Intake Depth: 01/10/2010 20 Nominal Pump Capacity: Horsepower: ADDITIONAL WELL INFORMATION Developed: Yes Fracture Enhancement:No Disinfected:Yes Well Seal Type:None Total Well Depth: 600.000 Depth to Bedrock: Comments: 6 -TON STANDING COLUMN WELL WELL DRILLER'S STATEMENT Driller: DENNIS BENNETT Supervisor: Michael C. Pelletier Rig #:69 Firm: Skillings & Sons, Inc. 15.000 Registration #: 754 Date Complete:01/11/2010 OVERBURDEN From To Description Color Comment Water Loss/Add Drill Drill (ft) (ft) Zone of Fluid Stem Drop Rate .00 5.00 Silty Sand & Gravel No N/A 5.00 15.00 Silty Clay No N/A 1/2 do r Massachusetts Department of Conservation and Recreation .Mussu<huserts Office of Water Resources 2/2 dc r Massachusetts Department of Conservation and Recreatioi Mnasa<busett Office of Water Resources Well Completion Report WELL LOCATION GPS North: 41° 57.527' GPS West: -710 19.267' Address: 2, N)OHAWK DRIVE Property Owner/Client: NEXAMP INC. Subdivision Name: City/Town: North Attleborough Assessors Map: Board of Health permit obtained: N Mailing Address: 21 HIGH ST, SUITE 209 City/Town, State:NORTH ANDOVER MA Assessors Lot #: Date Issued: 19 -JAN -10 16:41:45 Permit Number: 269785 Work Performed Proposed use Drilling Method Overburden Drilling Method Bedrock New Well Geothermal Open Loop Air Hammer Air Hammer CASING From (ft) To (ft) Type Thickness Diameter 2.00 -48.00 Steel SCREEN 17# 6.00 From (ft) To (ft) Type Slot Size Diameter FILTER PACK ABANDONMENT MATERIAL From (ft) To (ft) Material Descri X Ih20 LVI TOWN OF NORTH ANDOVER WELL TEST DATA (ALL SECTIONS MANDATORY FOR PRODUCT'"@Nm�, Date Method Yield Time Pumped Pumping Level Time to Recover Recovery (GPM) (hrs & min) (Ft. BGS) (Hrs & Min) (Ft. BGS) 01/14/2010 Air Blow with Drill Stem 4.0000 000:15 700.0000 024:00 38 STATIC WATER LEVEL (ALL WELLS) PERMANENT PUMP (IF AVAILABLE) Date Depth Below Ground Pump Description: Measured Surface (ft) Type: Intake Depth: 01/15/2010 38 Nominal Pump Capacity: Horsepower: ADDITIONAL WELL INFORMATION Developed: Yes Fracture Enhancement:No Disinfected:Yes Well Seal Type:None Total Well Depth: 700.000 Depth to Bedrock: 30.000 Comments: 5 -TON STANDING COLUMN WELL WELL DRILLER'S STATEMENT Driller: DENNIS BENNETT Supervisor: Michael C. Pelletier Rig #:69 Firm: Skillings & Sons, Inc. Registration #: 754 Date Complete:01/15/2010 OVERBURDEN From To Description Color Comment Water Loss/Add Drill Drill (ft) (ft) Zone of Fluid Stem Drop Rate .00 30.00 Till No N/A 1/2 dc r Massachusetts Department of Conservation and Recreation Nross��r..:ers: Office of Water Resources 2/2 I Standard Form of Agreement between Owner and RCG Builders LLC where the basis of payment is the Cost of the Work Plus a Fee without a Guaranteed Maximum Price 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 6 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: 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: 3 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 2of6 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: $24,983 7v,,,,, 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 any approved Change Orders. The Owner, Architect and Contractor will negotiate disputed Change Orders in good faith. Contractor's Fee: 15% of total construction volume up to $1 million, and 10% of construction volume over $1 million. 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 booked monthly in arrears. Specifically, 1. The cost of pre -construction and construction management services provided by RCG personnel is booked monthly in arrears based on the hours reported by each employee. 2. Hours are billed at the standard hourly billing rate established from time -to -time for each employee. The hourly billing rates effective 1/1/2007 are shown below. 3. The cost of pre -construction and construction management services provided by independent contractors is booked when invoiced and carried within the fee. 4. RCG Builders personnel functioning as tradesmen outside their management duties will be charged according to their hourly billing rate. 5. If a project is terminated or suspended by the Owner prior to completion, RCG Builders LLC is compensated for the actual cost of services provided prior to receipt of notice of termination or suspension from the Owner. 6. Total Construction Volume includes all construction trades, general requirements, insurance, bonds and miscellaneous costs deemed necessary to perform the construction of the project, but excludes permits and fees. Permits and Fees shall be paid directly by the Owner. 7. Construction management labor, standard tools and equipment, and labor -related overhead are covered "within the fee". Specialty tools or equipment, trade labor supplied by Builders personnel and approved transportation and meals costs shall be charged directly to the Owner without a fee. Employee Rate David Steinber h $125/hr Mike Bernier $125/hr Kieran Whelan $125/hr Jason Downing $50/hr Page 3 of 6 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. 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: ,r3°lo cb#ileas,';ur�lestulsec�re..I}a�r ,..f,... ....:. 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. Working Capital: RCG Builders shall not bear the costs of Working Capital for the project. If the Owner would like the Contractor to gain beneficial pricing on its behalf by paying subcontractors ahead of the Requisition schedule, the Owner shall either (1) put on deposit with the Contractor a sufficient amount of Working Capital for the Contractor to pay these Subcontractors, or (2) make immediate payment upon request from the Contractor outside of the normal Requisition process. Provision of Working Capital shall entitle the provider to all discounts and savings associated with that capital. Page 4 of 6 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. culi Z; �Oti9 ouch time that,.�tat�#icfon tll=ltaced is nra; ,fwne s 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: DeteSubanfxet-Cen let�i:t�beritett�r er 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 5 of 6 4. Signatures The Owner's representative is: David Ste�r�t,�rgK,� 064—tp RCCA LU'. 17 tvaton Street sSti�te 100 Somervl�e, � A�i2743 § 14.4 The Contractor's representative is: lC�eran d�ll�etan RCG Builders l.LC 17 !"aloo street Suitt 1,06 Someuille, t1AAQ2143 This agreement is entered into as of the day and year first written above and is executed in at least thre original copies, one for the Owner, one for the Contractor, and one for the Architect. Owner Co tractor Signa re Signature p Printed Name and Title YV- Printed Name and Title Page 6 of 6 Dowslake Microsystems Estimated Cost Schedule of Values Demolition $800.00 Dumpsters $575.00 Building materials $500.00 Frame & Insulate $1,000.00 Glass Entry Door & Sidelight $1,000.00 Drywall and tape $2,500.00 Prime and Paint (no ductwork) $1,500.00 Carpet (1,300 SF) $2,000.00 VCT (1,000 SF) $3,500.00 Vinyl base $300.00 Kitchen Cabinetry $1,600.00 Plumbing $800.00 Electrical $3,000.00 HVAC $2,500.00 Final clean $150.00 Sub -total $21,725.00 RCG Builders fee $3,258.75 Total $24,983.75 Plus Building Permit $300.00 Total Construction $25,283.75 im [ > jM � : � �0 ■_. \ ) © § g�115%' , | � w ■�, . No`Tk�y OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL PROJECT NUMBER: PROJECT TITLE: DOWSLAKE MICROSYSTEMS PROJECT LOCATION. 21 High Street, North Andover MA NAME OF BUILDING: 21 High Street NATURE OF PROJECT: Tenant Fit Out IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I, Jai Singh Khalsa REGISTRATION NO. 6042 BEING A REGISTERED PROFESSIONAL ENGINEERIARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT 0 ARCHITECTURAL -4 STRUCTURAL 0 MECHANICAL 0 FIRE PROTECTION ® ELECTRICAL U 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. ANO APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT] SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESSENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING: IN.ACCORDANCE WITH TI4IE 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 tate :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 i performed in a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRE � rH TOGETHER WITH PERTINENT. COMMENTS TO THE NORTH ANDOVER SPECT J, 42 UPON COMPLETION OF THE WORK; I SHALL SUBMIT A FINAL REPOR AMB y� SATISFACTORY C. OMPLETION:ANL? READINESS OF THE PROJEC PSS r, G(:. SI NATURE ASISCRI ORN TQ BEFORE ME THIS„ -DAY C)F NOTARY ftbCIdQo�. Addieg My COMMISSION EXPIRES � r nym ltl� of ryPubliwchusetFs mmission fires October 22'.. 2101)