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HomeMy WebLinkAboutBuilding Permit #645 - 21 HIGH STREET 5/27/2009BUILDING PERMIT ',"acl ,bgti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION r Permit NO: Date Received Date Issued: C� -1 0 SSACHus� IMPO TANT: Applicant must complete all items on this pate LOCATION 2,A ik� l Crv� k , PROPERTY OWNER Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shap Village no 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 Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: OWNER: Name: Z Y-tlk Please Type or Print Clearly) Address: `7 CONTRACTOR Name:'''""`- {-- Phone: Address: -L C,kt t -., Supervisor's Construction License: <-_ L3 Exp. Date: `t Home Improvement License: 16 Lk_' ExD. Date: ©1 r 4 ARCH ITECT/ENGINEER���►' —J^ LS1 i c -*".J tv-e- Phone: Address:�� i � 9� ,T �ZvSm,,m,�a RL eg. No. L3 L FEE SCHEDULE. BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BAS ON $125.00 PER S.F. Total Project Cost: $ 4� 6 0 FEE: $ Ct— '— Check No.: f5 Lt -0 Receipt No.:y� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund of 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 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 Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Locatea 664 Us ooa Street FIRE DEPARTMENT - Temp Dumpster on sito'yev n Located at 124 :Main Street Fire Department signature/date JCS' Dimension Number of Stories: ITotal square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector , Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A -F and G min.$100-$1000 fine NOTES and DATA — For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2008- Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o 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 DEPARTMENTMFORM07 Revised 2.2008 Location No. Date TOWN OF NORTH ANDOVER "WOW Certificate of Occupancy $ "us Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ��() 22661 Building Inspector 22242 ;� Building Inspector ,,Location,'*,,/ No. Date TOWN OF NORTH ANDOVER AL Certificate of occupancy Mu Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# t!�) V6 22242 ;� Building Inspector CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Permit 9 645 Qft 27, 02) Date, Lujy 23.2009 THIS CERTIFIES THAT THE BUILDING LOCATED ON 21 High Street — V10ha Waters MAY BE OCCUPIED AS Commercial Office S12ace ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCGN.A. Mills 21 High Street North Andover MA 01 845 Building Inspector m m m C m CA m 0 CD C � CO) CD n Z y CLO r O CL y ):loco -� O CD o p CDCL O Q �d CD o CD C CD CO) CSD '' L 0 CA CO CD I S p H O CD CD Z .O} O CD O CCD 6 F cn !'] cn C57S!o CL co m, CO) O .-► G �. Em. C. -T .►CS .d+0. C=L 0 T CD -P o CA _I _ g m • O O� : 0. R C O � C O ZH'n o ' m o am ?� • CI.5 cl, O N CD N d . N d d Q E C W— 0 ' a 4b 1o' C CD 0 m N CAQ:CD o o = d o U2 CD 0-* moo: CD ov�' NoC7 ,.. CD a_ A yCD • 0 CD x M CL z 0 U, 41 o ti C7 D 0 E �p a- r G oc x A D s o o = d o CD a z 0 U, 41 o ti O ~phi j ro �---' - ? C7 D 0 E �p a- r G oc x A D s o b cn alO a. n. d o CD a o. A O ~phi j ro �---' - ? �' E �p a- r G oc x ro r G G p CL QJ b cn alO a. n. d o CD a o. c x a� CD o Z n x Z 0 0 • KHALSA DESIGN INCORPORATED Architects & Engineers 17 Ivaloo Street, Suite 400, Somerville, MA 02143 p.617-591-8682 / f. 617-591-2086 ARCHITECTURAL FINAL AFFIDAVIT July 23, 2009 Town of North Andover, Building Department North Andover, Massachusetts RE: East Mill Tenant Fit -out, High Street North Andover Veolia Offices Khalsa Design Inc. has visited the above referenced project during the construction period, and has provided construction related services in conformance with the Massachusetts State Building Code, Controlled Construction Section, 780 CMR §116.0. 1 verify, that to the best of my knowledge, information and belief, that the building has been constructed in substantial conformance with the construction documents for the project. The detection of, or the failure to detect, deficiencies or defects in the construction during review by this office does not relieve the contractor or its subcontractors of their responsibility to correct all deficiencies or defects, whether detected or undetected, in all parts of the work, and to otherwise comply with all requirements of the Construction Docume �_��STEREOe,. _ Sincerely Yours, ted, Jai Singh Khalsa, NCARB Name Commission Expires Sara E. Addieg Notary Public Commonwealth of Massochusft My Commission Expires October 27, 2011 Mq Mass Registration Seal # 6042 Singh Khalsa made oath that the statement made Location 1. 'g,;P16 No Date Other Permit Fee $ TOTAL $ Check # 22243 9:��ullding InspeqG1 TOWN OF NORTH ANDOVER 0 AL 0 -e - Certificate of Occupancy $ MU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 22243 9:��ullding InspeqG1 n CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Permit # 645 CMU 27 09) Date: July 23 2009 THIS CERTIFIES THAT THE BUILDING LOCATED ON 21 High Street — Yi41ia Waters MAY BE OCCUPIED AS Commercial Office Space ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG N.A. Mills _ 21 High Street North Andover MA 01 845 Building Inspector Q W Cd O 0 0 a 0 H� � Q W M Oa O A v O aQi O 0 [ is O G Wid 00. ro C w U)w w Ui . n: r� cn "' w r�. as U) U) V •as c CA caO C v V Q C --- �: M •; m C C3vc m I' Yd L u O C � , w 3 r•+ Y= O O O Q fi LU % E CD�} v' CD c CL— h R m m L L O m3 c ;�� cm H W h Em dV L a H®m CM 0 CD 1 y �o.cz V y O v•�Z CO O H Q ND. .- m C = m C o CL..- W 0 -f - WC ea 'OZ LL O m r C +-� H •y •d = 9lv •go ���v O._ Ql a WS 0 Mo H L r0+ O.rm 0 z r T O F. 6 0 O �. O v Z CD CL O CO) � C CD cm I0 COD Cn 7070 CD O .O FE m m L- 0 CD H t 4.0 .0 3.0 O � CL -1 CD0 civ o a a. CMa CODc 0�� ccC \Y Li J .0 CL O lm C Z CD 0 CL �..� y O C .0 C Q. W W U) ACORD»a CERTIFICATE OF LIABILITY INSURANCE u5120/os°' .� PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION INSURANCE MARKETING AGENCIES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ! 306 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. WORCESTER, MA 01608 508 753-7233 INSURERS AFFORDING COVERAGE NAIC # INSURER x- Associated Employers Insurance 21865 RCG Builders LLC INSURER B: INSURER C. c/o RCG-LLC INSURER a. 17 Ivaloo Street, Suite 100 INSURERS Somerville, MA 02143 COVERAGES INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION LIMITS SR kDWL TYPE OF INSURANCE POLICY NUMBER EACH OCCURRENCE $ GENERAL LIABILITY DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY EMISES' F� OCCUR MED EXP (Arty are Person $ CLAIMS MADE PERSONAL 6 ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG i GEN'L AGGREGATE LIMIT APPLIES PER: POLICYr7l jRa LOC AUTOMOBILE LIABILITY COMBINED1t' SINGLE LIMIT $ acddANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILYINJURY $ (Per ecddeM) NON -OWNED AUTOS PROPERTY DAMAGE $ (Per ac:ddent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ EA ACC $ ANY AUTO OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBREILA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ _ $ $ DEDUCTIBLE $ RETENTION aWC WCC5005531012009 05/10109 05/10110 STATU- OTH- X E.L. EACH ACCIDENT $500,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY E.L. DISEASE - EA EMPLOYEE $500OOO ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED? $500000 If describe under SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT OTHER I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS DESCRIPTION OF OPERATIONS w --.w -, , CTIA►r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATH M For informational Purposes BATE T' w&w. THE ISSUING IHSurER wni ENDEAVOR TO MAIL —10- DAYS WRrrTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Orr FAILURE TO DO SO SHALL tMIPOSE NO OBUGATION OR LIABILITY OF ANY KBO UPON THE HNSUFA3k ITS AGENTS OR ....rc A ACORD CORPORATION 1981 ACORD 25 (2001103)1 of 2 95153999IM10owu T -'-- The Commonwealth of Massachuset& Department of Industrial Accidents Office of Investigations . 600 lCashington Street Boston, MA 02111 r' www_nwss gov/dia . Workers' Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers apiicant Infnrmatian . n Naasrgan (Business/Oization/Individual): r�— C Q t Ad&ess: S v t� ^� City/State/Zip: Phone-- �--Syn=x,77 Are you an employer? Cheek.the appropriate box: I. [] I am a employer with 4, ❑ I am a general contractor and I employees (fulland/or part-time).* 2.[3 I am .a:sole proprietor or have Mired the sub-comraetors listed partner- ship and have no employees on the attached sheet, i These scth-contractors have working for me in any capacity, [No workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its required,] 3. ❑ I am a homeowner doing officers have exercised their all work right of exemption per MGL myself; [No -workers' comp. r 152, § 1(4), and we have no insurance required.] t employees. [No workers' camp. insurance required.] Type of project (requires: 6. ❑ New construction . 7. 2 Remodeling 8. ❑ Demolition 9. [] Building addition 10.❑ Electrical repairs or additions I 11 Plumbing repairs or additions 12.❑ Roof repairs 13.❑.Other `l+try applicant that checks ba# l must also fill out the section below showing theirworkers'60mPnsation cy l an him outside contnaetars mul T liomeowniq who submit this affidavit indicating they ars doing an work end thot rubor a neve affidavit indicating such ;Contractors that check this box rwatettaclted sn sdditionsJ rhea showir;g. t:he name ofthe sub -contractors and their workers' temp s' r F" ,, i-famuuion t am an employer that is prowdR. workers' compensat►on hnsarawe for my eMployees: Below is the policy and job stir information Insurance Company C L a _ r- v V r -�.ar �+ Policy # or Self -ins. Lie. #:_,/.I C-4- ry ^ Expiration Date: �S o ( p Job Site Address:�� Zr-wi^ City/State/Zip: 4 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration dates). 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 againsGthe 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 �� A ce/,1��, lit fy under the pains and penaiam of perjary Mat the information f provided above is true and eonrel _ t-6`7? Official use only. Do not write in this area, m be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): L Board of Iieaitb 2 Building Department 3. City/Towu Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other 1 Contact Person: Phone #: Information a end Instructions f Massachusetts General Laws chapter 152 requires all emp Ioyers 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, assodiation, corporation or other legal entity, or any two or more of the'fareping engaged in a joint enterprise, and includirig 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 maimtenance, 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 *o construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance wkb 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 ins=m= requirements of this chapter have been presented to the cordrecting authority." Applicants Please fill out the workers' compensation• affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es): and phone number(s) along with their certificates) 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 forthe permit or license is being requested, not'the.Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please can the Department at the numberlisted below. Self-insured companies should enter their seat -insurance -license number on the'appropriate tine. 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 permit/Iiceme 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 fist= permits or licenses. A new affidavit must be filled out each year. When 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 bum 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 Envestii ations 600 Washington Street Boston, MA 02111 TeL # 617-7274900 ext 406 or 1-977-MASSAFE Fax # 617-727-7744 Revised 5 -26 -QS www.mass.gov/dia Ems* Q rA rA w O A o a u w° a C/)w° Li 1~ i Q u W wo' .fit .1 J= � w o wo' NGO C� w- \ w O A o a u w° a C/)w° U w r_4 z a C wo' U w 0 w wo' w AG pF a �, ,� u � "8 cn a+ w o H a z t o a w z A w rA zG V) ooo cn O** OI `oc n «. N �V m O L L c 03 N O C" .m = c N E" CD *r y m O o o ,~ C N Q *—,CO=2 oao m N m K*- C m _-. 3 H w y m W C =• flt O j;A is ui=6Z LJ= •E u = V zCOD a o� c: -;ac: -;a= cca�y�� H = 0- aim E \O L M v / N o H C _ o w v cm m o 'L-4 Lo cm c' �c N m _ r 0 Z , O o� 5a Z O U I M L O O co O v z °' CL O H i O Om COD O CD y O �O m m 0 CD CL �+ � R � O 211 CD 0CD Q _ca o a e a cm< h C .4" c eo w 9 .Q Q? c Z CD V CO) cc C C cc CLCO2 0 V �: cQ -�m c C) C., GS .nom CLC ev cv c co E a C CD Q I ` �r V CD a 4 � C O** OI `oc n «. N �V m O L L c 03 N O C" .m = c N E" CD *r y m O o o ,~ C N Q *—,CO=2 oao m N m K*- C m _-. 3 H w y m W C =• flt O j;A is ui=6Z LJ= •E u = V zCOD a o� c: -;ac: -;a= cca�y�� H = 0- aim E \O L M v / N o H C _ o w v cm m o 'L-4 Lo cm c' �c N m _ r 0 Z , O o� 5a Z O U I M L O O co O v z °' CL O H i O Om COD O CD y O �O m m 0 CD CL �+ � R � O 211 CD 0CD Q _ca o a e a cm< h C .4" c eo w 9 .Q Q? c Z CD V CO) cc C C cc CLCO2 0 Board ��ff�oBaNing RWbtiow and SUdw& j 3 xCmatru��� Supervisor Lkmm I License: CS 66334 z Sifdxh s: $12811956 1 Expiration: 9126/2009 Tr#t 3960 PAsbktion: 00 KIERANT WHELAN, � 1 31 RICHMOND ST f WEYMOUTH, MA 0218$ Commiasioaer { OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER +15 :. CONSTRUCTION CONTROL a r. • �a% aaee»+xs PROJECT NUMBER; PROJECT T1TLEt VEOLIA OFFICES 21 High Street North Andover MA PRC}JECT LCICATiox9 NAME OF BUILDING: 21 High Street NATURE OF PROJECT: Tenant Fit Out IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, l Jai Singh Khalsa REGISTRATION No. 6042 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 QARCHITECTURAL STRUCTURAL 0 MECHANICAL O FIRE PROTECTION 0 ELECTRICAL D 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. I 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 APPROVER 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, sampies 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 Wth6the 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. TO SECTION 11$.2.2 1 SHALL SUBMIT WEEKLY A PROGRESS REPORT ITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. Exe3'C P TION OF THE WORK, I SHALL SUBMIT A FINAL REPORT A TO THE I O Y COMPLETION AND READINESS OF THE PROJECT FOR O CUPANCY. a ED .AND SWORN TO BEFORE ME THIS 241' DAY OF URE NOTARY PU LIC MY COMMISSION EXPIRES S��/ 2 Z d1 BUILDERS 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 BUILDERS 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 CorXiimercial General Liability$1 ,OOQ.QQ ..Mr 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 6 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: $46;4;60:00 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, 4 R 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. 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. The cost of pre -construction and construction management services provided by independent contractors is booked when invoiced and carried within the fee. RCG Builders personnel functioning as tradesmen outside their management duties will be charged according to their hourly billing rate. 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. 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. 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: BUILDERS 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: 10% of billed -costs,;unless otherwise approvooy the Owner ' 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. May.- -2009, oriiUc' h time that Notirticat�ort to Proceedy is given by, Owrier� 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: Date`of Substantial Com letion to be no later than atl 31,;2009 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 BUILDERS 4. Signatures The Owner's representative is: David Steinberg', Principal RCG LLC 17 Ivaloo Street, Suite 100' Somerville, MA 0214� 113 § 14.4 The Contractor's representative is: ............. Kieran Whelan. RCG Builders LLC 17 Ivaloo Street, Suit 6`10 .............: Somerville, MA 02143 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 Contractor Signa e Signature Printed Name and Title Printed Name and Title Page 6 of 6 Veolia Water Construction Budget Demo 3 walls, glass and carpet removal Building materials Frame walls [extra furring needed for some walls $3,500.00 Doors and windows $1,500.00 Drywall Tape, compound ,sand, prime and paint Frame walls, drywall, tape and compound $10,950.00 Prime and Paint $6,000.00 Carpet $4,000.00 Vinyl base $500.00 Plumbing $500.00 Electrical $7,500.00 HVAC $4,800.00 Glass in entry door $450.00 Dumpster $550.00 Final clean $150.00 Sub -total $40,400.00 RCG Builders fee $6,060.00 Total $46,460.00 Plus Building Permit $564.00