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Home My WebLink AboutBuilding Permit #368 - 211 ROSEMONT DRIVE 12/1/2008 BUILDING PERMIT of"o DTN TOWN OF NORTH ANDOVER 0 - .`_ o� APPLICATION FOR PLAN EXAMINATION x Permit NO: Date Received /` �gsSACH�15 Date Issued: s 01� IMPORTANT: Applicant must complete all items on this page LOCATION, �. Printx, PROPERTY-01NNER, T Print MAP"NO: PARCEL: ZONING bISTRICT: Ilstodc District _.. yes_. bno "Machine-,Shop 1%illage yes � no A TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other '.Septic 1/e11 Floodplain Wetlands n 1lVater. hed District ` z�Wated,Sevuer -in. M DESCRIPTI N OF WORK TO BE PREFORMED: Identification Please Type or P 'nt Clearly) OWNER: Name:_ .Q i � �-pr G�,o6 p ,o � Phone: 7�� Address: CONTRACTOR Nam " e' Phony. ,Addr ss. CA e N. P- Q . Supervisor's�Construcbon-Licenser -�Ex 'Dater HomeMlrriprovemertt License �. '7' � v .Exp. flats:''' -kv ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �7(®, � l�� FEE: $ Check No.: Receipt No.: 0 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ignatur of Agent/Owne _ Signeitur=e of contractor v 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: Signature: Located 384 Osgood Street 'FIRE�OEPARTME'NT Temp D m ster on site =yes no, Located at 124 Main Street- j f ire Department signature/date r COMMENTSAK _ r . . Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of.Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A-F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date ------...._................................................-- ----..........................................._....__.._.._...__.......__..............._..._._._..........._._._ ....---.._..._..............__..........._...._._ _....._...._..................................................... Doc.Building Permit Revised 2008 Building Department artment - The followingis a list of the required forms to be filled out for theappropriate ermit to be obtained. qP Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ' ❑ Workers Comp Affidavit o 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 i I I Doc:Building Permit Application i Revised 2.2008 r, Location- No. v Date k MORT� TOWN OF NORTH ANDOVER ' ( Certificate of Occupancy $ sttBuilding/Frame Permit Fee $ Foundation Permit Fee $ �. ``v, " Other Permit Fee $ TOTAL $ F, Check # v 2 { � 24 2 Building Inspector ®RTH own o ' Andoover , a4p .L K E .� dover,er, MaSS.� • o /�. COCHICNEWICK V RATED pPG �C� G BOARD OF HEALTH PERM IT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... .. ......irv..4................ ... .. .1 /.... .. ............: .......................................... Foundation has permission to erect............................ buildings on �. ...... . ............ bUlldln .. ...............®....... ....... .._ Rough 10% to be occupied as...:. ........ .................:............ ... ....................................................................................I.................. '64110Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final 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 13 -4 ® PERMIT EXPIRES 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS UC ST Rough :............................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy .wilding GAS INSPECTOR 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. Burne Street No. SEE REVERSE SIDE Smoke Det. CONSTRUCTION CONTRACT Witness this agreement made, effective as of this f o da —2008 b Y �rOV , y and between David H. Nelson, d/b/a D. H.Nelson Construction of Pepperell, Middlesex county, Massachusetts in this contract as CONTRACTOR, and Harsh Sanchorawala, of 211 rosemont drive North Andover MA , 01845 referred to in this contract as OWNER. SECTION ONE DESCRIPTION OF WORK Demo existing kitchen cabinets and remove existing floor covering install new tile floor(tile supplied by owner) install new kitchen cabinets and vent for hood as well as install new appliances, paint for kitchen only (ceiling ,walls and trim in kitchen) (ANY UNFORSEENS ARE EXTRA, PRICED @ 60.00 PER HOUR PER MAN AT OWNERS APPOVAL in writing) BUILDING PERMIT IS AN EXTRA CHARGE TO OWNER CONTRACTOR shall perform all work according to the following specifications: A. All details outlined in the Building Plans, attached hereto and incorporated herein by reference ;spec list B. All details outlined in the Specifications, along with any amendments thereto, attached hereto and incorporated herein by reference; C. All modifications set forth in the Modifications Schedule (if applicable), attached hereto and incorporated herein by reference; and D. All applicable terms and conditions as set forth in any and all price or work details and work details/estimates of sub-contractors, attached hereto and incorporated herein by reference. The OWNER shall prepare Site according to the plans attached hereto, and thereafter the CONTRACTOR shall supply the labor and materials necessary to complete the construction required by said plans and specifications. SECTION TWO CONTRACT PRICE The OWNER agrees to pay the CONTRACTOR for the work described in the Plans, Specifications, Modification Schedule and Price Details, sixteen thousand one hundred and .p 4 e � 00/100 ($16100'00) dollars, of which five thousand three hundred sixy six and 67/100 (5366.67) dollars has been paid as a deposit to be used by the CONTRACTOR to complete its obligation under this contract. SECTION THREE PROGRESS PAYMENTS A. Based upon Applications for Payment submitted to the OWNER by the CONTRACTOR, the OWNER shall make progress payments: (1) $5366.67.00 upon signing of this agreement; 2 $ 3577.78 upon completion of dem a ( ) o and rough wiring p P g nng and plumbing disconnects (3) $ 3577.78 upon completion of floor heat install and start of tile work (4) $ 3577.77 upon completion of this contract * Material prices subject to change without notice due to rising fuel costs. * Permit fees are not included in contract price B. Work stoppage may occur if Progress Payment is not made by OWNER with in fourteen (14) days of the date set forth above or within fourteen (14) days on the completion of work set forth above. Any cost incurred due to late payments and outstanding balances, including attorneys fees to collect such, shall be paid by the OW' l TR. C. Progress payments may be withheld if: (1) Work is found defective and not remedied within 30 days after notice is given to CONTRACTOR, in writing, as to the kind type of defective; (2) Claims or liens are filed on the job; (3) CONTRACTOR fails to make payments properly to Sub-contractors for labor, materials or equipment; or (4)Persistent failure to carry out the Work in accordance with the Contract documents. SECTION FOUR FINAL PAYMENT A. OWNER shall make final payments to CONTRACTOR upon completion of work. The initial deposit shall be credited against the balance due the CONTRACTOR as the final payment. B. Completion of said project.shall be contingent upon; (1) Compliance with all of the aforementioned work specifications listed in Section One; and f t (2) Inspection and approval of said project site by the Town north andover mass .> indicating said work conforms with all specifications and issuance of Certificate of Occupancy(if applicable). C. In instances where CONTRACTOR deems himself to be financially insecure with respect to OWNER'S ability to pay any payments, CONTRACTOR may require that the balance of the funds not yet due be placed in a joint escrow account as a prerequisite to continuing the Work. Withdrawal from said joint account would require the signatures of both parties or an order from the Court. D. CONTRACTOR, by accepting final payment, waives all claims except those that he or she has previously made in writing, and which remains unsettled at the time of acceptance. SECTION FIVE STARTING AND COMPLETING DATES Construction under this contract shall begin 4?10 2, , and be completed-1' 6 4 ) , unless that day or time shall be extended as provided hereafter, r by e dorsement agreed by the parties and set forth in writing and signed by the parties; to which, in such case, on or before the extended day or time.The time for completion shall also be automatically extended if the CONTRACTOR delayed in completing the Work due to any of the following reasons: 1) strikes; 2) unavailability of materials; 3)acts of nature; 4) stormy or inclement weather; 5) any of the OWNER'S actions; 6) Change Orders; 7)the OWNER'S failure to pay according to the Payment Schedule; 8) actions by other or circumstances which are beyond the CONTRACTORS control. SECTION SIX CONTRACT DOCUMENTS A. The Contract Documents on which the agreement between the OWNER and the CONTRACTOR is based,that contain the plans and specifications in accordance with which the work is to be done, and provide for the method of payment of the contract price as follows: 1 This agreement and the plans and specifications O g p p cifications described herein m SECTION ONE; and (2) Work change orders when reduced to writing and agreed to by the OWNER and CONTRACTOR. B. The contract documents together form the contract for the work described in this agreement. The parties intend that the documents include provisions for all labor, materials, equipment, supplies, and other items necessary for the execution and completion of the work, and all terms and conditions of payment. The documents also include all work and procedures not expressly indicated in such documents necessary for proper execution of the above described project. C. The contract documents are to be separately executed in triplicate by the OWNER and the CONTRACTOR. The CONTRACTOR, by executing the documents, represents that it has inspected and is familiar with the work site and the local conditions under which the work is to be performed. SECTION SEVEN RIGHT AND RESPONSIBILITY OF OWNER A. OWNER shall give all instructions directly to the CONTRACTOR and shall not deal directly with the sub-contractor, shall furnish all necessary surveys for the work, and shall secure and pay for easements for permanent structures or permanent changes in existing structures or facilities on the work site or which are necessary for its proper completion. B. OWNER shall pay for the building permit and for all other permits and government fees, licence and inspection necessary for the proper execution of the work. C. The OWNER will have authority to reject work, in writing, which does not conform to the contract documents. D. If the CONTRACTOR fails to correct defective work or persistently fails to carry out the work in accordance with the contract documents, the OWNER, by written order, may order the CONTRACTOR to stop the work, or any portion thereof, until the cause for such order has been eliminated; however, this right of the OWNER to stop work shall not give rise to any duty on the part of the OWNER to exercise this right for the benefit of the CONTRACTOR or any other person or entity, and shall not allow the OWNER to delay payments for satisfactory work completed. E. OWNER shall pay for the removal of debris, obstructions, above or below the ground, correction of any unforeseen conditions and correction of the site or building defects necessary to do the work. OWNER will clear the work area of all personal property. F. OWNER shall provide any water, gas electric, lavatory and/or storage facilities necessary to complete the work, and CONTRACTOR shall not be responsible for delays due to interruptions of said services or unavailability of facilities. SECTION EIGHT RESPONSIBILITIES OF CONTRACTOR t CONTRACTOR'S duties and right in connection with the above described project are as follows: A. Responsibility for and supervision of construction. CONTRACTOR shall be solely responsible for all construction under this contract, including the techniques, sequences, procedures, and means, and for coordination of all work. CONTRACTOR shall supervise and direct the work to the best of its ability, and give it all attention necessary for such proper supervision and direction. B. Obtaining of permits. The following building permits required. Building Permit, Electrical Permit, except plumbing permit (owners resposability) CONTRACTOR shall secure such permits as the OWNER'S agent. OWNERS who secure their own permits are excluded from the guaranty fund provisions of M.G.L.c.142A. C. Furnish of labor, materials, etc. CONTRACTOR shall provide all labor,materials, and equipment, including tools, construction equipment and machinery, transportation, and all other facilities and services necessary for the proper completion of work on the project in accordance with the contract documents. Where materials are to match, CONTRACTOR will make a reasonable effort to do so, but does not promise an exact match. CONTRACTOR owns all materials, even if stored on the O V'NERS premises, until paid for by the OWNER. Should OWNER fail to pay CONTRACTOR when due, CONTRACTOR shall have the right to bring an action in repletion against the OWNER to recover materials and equipment. All surplus materials are the property of the CONTRACTOR, and all material salvaged from any demolition are the property of the OWNER. CONTRACTOR reserves the right to reasonably substitute materials of substantially equal or greater value and quality if items described and listed in all specification or subsequent change orders, (which are in writing and mutually agreed upon by the parties and require additional cash deposits)which are not readily available in time to complete the scheduled work activity. D. Compliance with Construct-ion Laws and Regulations. CONTRACTOR shall comply with all laws and ordinances and the rules regulations, or orders of all public authorities r � � Blatin to P g the performance of the work under and pursuant to this agreement. E. Warranty Of Fitness of Equipment and Materials. CONTRACTOR represents and warrants to OWNER that all equipment and materials supplied by its used in the work, or placed permanently in connection with such work, will be new unless otherwise specified in the contract e y documents, of good quality, free of defects, and in conformity with contract documents. It is understood and agreed between the parties to this agreement that all equipment and materials supplied by the CONTRACTOR not so in conformity will be considered defective. F. Clean-up. CONTRACTOR agrees to keep the work premises and adjoining ways free of waste material and rubbish caused by his or her work or that of his or her sub contractors. CONTRACTOR further agrees to remove all such waste material and rubbish on termination of the project, together with all it's tools, equipment, machinery, and surplus material. CONTRACTOR agrees, on terminating it's work at the site,to conduct general clean-up operations. G. To the fullest extent permitted by law, the CONTRACTOR shall identify and hold harmless the OWNER and its agents and employees from and against all claims, damages, losses, and expenses, including but not limited to attorney's fees arising out of resulting from the performance of the work,provided that any such claim, damage, loss or expense (1) is attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property (other than the work, itself) including the loss of use resulting there from, and (2) is caused in whole or in part by any negligent act or omission of the CONTRACTOR, regardless of wether or not it is caused in part by a party indemnified hereunder. Such obligation shall not be construed to negate, abridge, or otherwise reduce any other right or obligation of indemnify which would otherwise exist as to any party or person described in this paragraph. In any and all claims against the OWNER or any of its agents or employees by an employee of the CONTRACTOR, any sub-contractor, anyone for whose acts any of them may be liable,the indemnification obligation under this paragraph shall not be limited in any way by any limitation on the amount or type of damages, compensation or benefits payable by or for the CONTRACTOR or any sub contractor under workers' or workmens' compensation acts, disability benefit acts or other employee benefit acts. The obligation of the CONTRACTOR under this paragraph shall not extend to the liability of the OWNER, its agents or employees, arising out of(1)the preparation or approval of maps, drawings, opinions, reports, surveys, change orders, designs or specifications, insofar as any of the same is the responsibility of the OWNER under this contract, or(2) the giving of or the failure to give directions or instructions by the OWNER, its agents or employees provided such giving or failure to give is the primary cause of the injury or damage, and provided further, that the giving of said directions and instructions are the responsibility of the OWNER under this contract. SECTION NINE TIME OF ESSENCE; EXTENSION OF TIME A. All times stated in this agreement or in the contract documents are of the essence. B. The Date of Substantial Completion of the Work is the date when construction is sufficiently complete so that the O-\VNER can occupy or utilize the work for the use it was intended. C. The times stated in this agreement or in the contract documents may be extended by a change order for such reasonable time as the CONTRACTOR is delayed in work progress by changes ordered, fire, prolonged transportation delays, or other causes beyond CONTRACTOR'S control or which justify the delay, or as set forth in Section Five of this agreement. SECTION TEN SUB-CONTRACTORS All contracts between CONTRACTOR and sub-contractors shall conform to the provisions of the contract documents, and shall incorporate in them the relevant provisions of this agreement. Unless otherwise required by the Contract documents'or in the Bidding documents ,the CONTRACTOR, as soon as practical after the award of the Contract, shall furnish to the OWNER in writing the names of sub contractor for each of the principle portions of the work. The CONTRACTOR shall not employ any sub contractor to whom the OWNER may have a reasonable objection. The CONTRACTOR shall not be required to contract with anyone to whom he has a reasonable objection to. Contracts between the CONTRACTOR and the sub-contractor shall (1) require each sub contractor, to the extent of the work to be performed by the sub- contractor, to be bound to the CONTRACTOR by the terms of contract documents, and to assume toward the CONTRACTOR all obligations and responsibilities which the CONTRACTOR, by these documents, assumes toward the OWNER, and (2) allow to the sub-contractor the benefit of all rights, remedies and redress afforded to the CONTRACTOR by these contract documents. All I QQ/'v sub-contractors shall provide evidence of insurance to CONTRACTOR and OWNER prior to commencement of any work at the project site. SECTION ELEVEN INSURANCE A. CONTRACTOR'S Liability Insurance. CONTRACTOR agrees to keep in force at his or her own expense during the entire period of construction on the project such liability insurance as will protect it from claims, under Workers' Compensation and other employee benefit laws, for bodily injury and death, and for property} dama e, that may arise out of work under this agreement, , wether directly or indirectly by CONTRACTOR, or directly or indirectly by sub-contractor. The minimum liability limits of such insurance shall not be less than one million dollars. Such insurance shall include contractual liability insurance applicable to CONTRACTOR'S obligations under this agreement. CONTRACTOR shall file proof of such insurance with OWNER upon execution of this agreement. E. OWNER'S Liability Insurance. OWNER agrees to maintain in force his or hers own liability insurance during the construction on this project, and reserves the right to purchase such additional insurance as in his or her opinion is necessary to protect him or her against claims arising out of the CONTRACTOR'S operations, without diminishing CONTRACTORS obligation to carry the insurance specified in this agreement on CONTRACTOR'S part to be carried. C. Property Damage Insurance on Work Site. OWNER agrees to maintain at his or her expense during construction of the project property damage insurance on the work at the site to its full insurable value, including interest of OWNER, CONTRACTOR, and sub contractor, against fire vandalism, and such other perils ordinarily included in extended coverage. Losses under such insurance will be adjusted with and made payable to OWNER as trustee for the parties insured as their interest appear. OWNER shall file a copy of all such policies with CONTRACTORS within a reasonable time after construction begins under and pursuant to this agreement. D. Waiver of Work Site Property Damage Claims to Extent of Insurance Coverage. OWNER and CONTRACTOR hereby waive all claims against each other for fire damage or damages from ,t other perils covered by insurance provided in paragraph C of this section. The CONTRACTOR shall require similar waivers in favor of the OWNER and CONTRACTOR by subcontractors and sub-subcontractors. SECTION TWELVE WORK CHANGES A. OWNER reserves the right to order work changes in the nature of additions, deletions, or modifications, without invalidating this agreement, and agrees to make corresponding adjustments in the time for completion. B. All changes will be authorized by a written change order signed by OWNER The change order will include conforming changes in the agreement contract and completion time C. Work shall be changed, and the contract price and completion time shall be modified only as set out in the written change order. D. Any adjustment in the contract price resulting in a credit or a charge to OWNER shall be determined and paid and/or credited by mutual agreement of the parties before starting the work involved in the charge. E. It is expressly agreed and understood that any allowances unused by the OWNER will be credited against the next payment due the CONTRACTOR. SECTION THIRTEEN TERMINATION A. CONTRACTOR'S Termination. CONTRACTOR may, on seven days notice to the OWNER terminate this agreement before the completion date specified in this agreement when for a period of five days after progress payment is due, through no fault of CONTRACTOR the OWNER fails to make a payment. On such termination, CONTRACTOR shall recover from OWNER payment for all work completed and for any loss sustained by CONTRACTOR for materials equipment, tools, or machinery to the extent of actual loss thereon plus loss of a Oki reasonable profit, provided it can prove such loss and damages. B. OWNERS Termination. OWNER may, on seven days notice to CONTRACTOR, terminate this agreement before the completion date specified in this agreement, and without prejudice to any other remedy it may have, when CONTRACTOR defaults in performance of any provision in this agreement, or fails to carry out the construction in accordinance with the provisions of the contract documents. On such termination, OWNER may take exclusive possession of the work site and all materials, on the work site, and finish the work in whatever wait it deems expedient. If the unpaid balance on the contract price at the time of such termination exceeds the expense of finishing the work,OWNER will pay such expenses to CONTRACTOR. If the expense of finishing the work exceeds the unpaid balance at the time of termination, CONTRACTOR agrees to pay the difference to the OWNER. C. On any such default by CONTRACTOR, the OWNER may elect not to terminate this agreement, and in such event it may make good the deficiency of which the default consists, and deduct the cost from the progress payments then or to become due to CONTRACTOR. SECTION FOURTEEN ARBITRATION CONTRACTOR and OWNER hereby mutually agree in advance that in the event CONTRACTOR has a dispute concerning this agreement, CONTRACTOR may submit such dispute to private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the OWNER shall be required to submit to such arbitr nfas or inM.G.L.c.142A. CONT CT R ! ��1 l �1 OWNER/S ( Date: Date: 11 — SECTION FIFTEEN GOVERNING LAW It is agreed that this agreement shall be governed by, and enforced in accordinance with the laws of the commonwealth of mass. s SECTION SIXTEEN ATTORNEY FEES In the event that either party violates the provisions of this agreement, sais party shall be responsible to pay any and all reasonable costs and attorney's fees necessary to enforce said i agreement. SECTION SEVENTEEN ENTIRE AGREEMENT This agreement shall constitute the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this agreement shall not be binding upon either party except to the extent incorporated in this agreement. SECTION EIGHTEEN MODIFICATION OF AGREEMENT Any modification of this agreement or additional obligation assumed by either party in connection with this agreement shall be binding only if evidence in writing signed by each party. SECTION NINETEEN NOTICES Any notice provided for or concerning this agreement shall be in writing and be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each as set forth at the beginning of this agreement. p�'h' g D SECTION TWENTY ASSIGNMENT OF RIGHTS The rights of each party under this agreement are personal to that party and may not be assigned or transferred to another person, firm, corporation, or other entity without prior, express, and written consent of the other party. SECTION TWENTY-ONE PARAGRAPH HEADINGS The titles to the paragraphs of this agreement are solely for the convenience of the parties and shall not be used to explain,modify, simplify, or aid in the interpretation of the provisions of this agreement. Unless otherwise noted within this document, this agreement shall not imply that any lien or other security interest has been placed on the residence. In witness, each to this agreement has caused it to be executed on the date indicated P�'h' b Gated below. CONTRACTOR: OWNER: n t sign this contract if there.are lank spaces. H! i David H.Nelson Hash anchorawala 4 Cross Street 1 11 Rosemont drive . Pepperell, MA 01463 North Andover ,MA.01845 Date: �� v Date: Lic# 85793 Reg 4146411 Any inquires about a contractor or subcontractor relating to registration should be directed to: Director Home Improvement Contractor Registration One 'Ashburton Place, Room 1301 Boston, MA 02108 617-727-8598 �RJ i D.H.NELSON CONSTRUCTION 4 CROSS STREET PEPPERELL,MA 01463 spete list NAME/ADDRESS HARSH SANCHORAWALA 211 ROSEMONT DRIVE NORTH ANDOVER,MA 01845 PROJECT DESCRIPTION TOTAL TEAR OUT OLD KITCHEN CABINETS AND REMOVE EXISTING FLOOR COVERING AND 1.200.00 UNDERLAYMENT(if existing underlayment is glued price for removing n800.00 per day two men additionally) 15 YD.DUMPSTER 500.00 INSTALL NEW HOOD AND VENT(VENT TO OUT SIDE IF JOISTS RUN PERPENDICULAR A 400.00 SOFIT NEEDS TO BE BUILT TO COVER VENT PIPE L-50.00 PR.HR.PR.MAN) WARMUP FLOOR HEAT 320 SQ.FT.OF COVERAGE(240 VOLT)(INSTALLATION OF HEAT 3,600.00 WIRE WITH DETRA(350SQ.FT.)CRACK SEPARATION MATERIAL OVER WIRE INSTALLATION OF 350 SQ.FT. OF TILE OVER DETRA(PRICE DOES NOT INCLUDE TILE)plus 3,000.00 urethane grout INSTALLATION OF TILE BACK SPLASH AND HOOD AREA TO CEILING(standard install ceramic 750.00 or porcelain tile on standard grid) allowance for install 750.00 KITCHEN CABINET INSTALL(READY FOR TOPS)TOPS NOT INCLUDED 2.4000.00 APPLIANCE INSTALL(REFER, STOVE,DISH WASHER AND MICROWAVE 400.00 Plumbing(DISCONNECT EXISTING DISH WASHER,SINK STOVE,AND REFER CONNECTION'S 1.200.00 FOR DEMO T14EN RECONNECT TO NEW ANY UNFORSEENS WILL BE BILLED.t TIME AND MATERIALS) Electrical&Lighting(KITCHEN ONLY)WIRE FOR NEW PENDANT LIGHTS ALSO UNDER CAB 1,000.00 LIGHTS AND NEW DISH WASHER AND HOOD contract fee 150.00 Plans&Permits fees are extra PAINT KITCHEN CEILING,WALLS AND TRIM 1500.00 ALLOWANCE TIME AND MATERIALS 1.500.00 THIS ESTIMATE IS GOOD FOR 14 BUSINESS DAYS TOTAL $16.100.00 The Co s� mmonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 { www.mass.gov/dia Workers' Compensation Insurance Mfidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leo-ibiy Name (Bus in''essls/Organization/in div idual): � V� Address: City/StatelZip Phone #:-5,) 8D f� Are you an employer?Check the appropriate box: 1.❑ I an a employer with 4. ❑ I am a general contractor and I Type of project(required); employees(full and/or part-time).* have hired the sub-contractors 6. Q New construction 2�]l I am a sole proprietor or partner- listed on the attached sheet. $ ?• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and'its 9 E] Building addition required.] officers have exercised.their 10:❑ Electrical repairs or additions 3.❑ I an a homeowner doing all work right of exemption per MGL 1 1.❑ Plumbing repairs or additions myself. [No.workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 1.3.0 Other +Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. Homeowners who subnLl this aE%Idavit i11d'eatill tiiej'at'c uulEt 1.ii+drk and€hen hire outside contraciors unci submit a new am`eavit indicating such. xContnactors that check this box must attached an additional sheet showing the name of the sub-contractors and their worker;'comp.policy information. I am ann employer that is providing workers'compensation insurance information for my employees. Below is the policy and job site Insurance Company Name: Policy#or Self-.ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 S i cmature: Qate: Phone#: Official use only. Do not write in this area, to becompletedby 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#: 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-contractors)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 carryworkers' 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 anddate 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 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 narnber•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 permitAicense 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 Invesfigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26=05 Fax#617-727-7749 www.mass.gov/dia I i C 86ed IOS988VLI9 ZZ40 SOiI-800Z AG&RD. i/02M PrawcaR THIS CERTIFICATE A MATTER OF INFOPUMION ONLY AND CONFERS No RIaHTs UPON THE CERTIFICATE Brown&Brown of New Hampshire,Inc. HOLDER. THIS CERTIFICATE CDoe$NOT AMEND,EXTEND OR PQ Box 1497 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pepperell,MA 01463 CQMPANIESVFORDING COVERAGE COMPANY A Atlantic Garter Insurance Co an VDAC COMPANY avid 11.Nelson g 4 Cross St COMPANY C Pepperell,MA 01463 COMPANY 11111 D THIS G TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED Tp THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDmON 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 IB SUIUECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED Fly PAX)CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFF!Cvm POLICY W(PIRATION UNITS LTR DATE(MUMMM DATE(MMIDOJM Ia1 ThowtnWeD GENERAL UABILITY BODILY INJURY OCC i COMPHEHENMvE FORM BODILY INJURY AGG i PREMME810PERATIONS PROPERTY DAMAGE OCC i UNDERGROUND PROPERTY DAMAGE AGC S EXPLOSION i COLLAPSE HAZARD III 6 PD COMBINED OCC $ PRODUCT31COMPLETM OPER 91 A PO COMBINED AGG i CONTRACTUAL PERSONALiNJURYAGG i INDEPENDENT CONTRACTOR.9 BROAD FORM PROPERTY DAMAGE PERSONAL INJURY AUTOMOBILE UABIUTY BODILY INJURY ANY AUTO (PW 0 ., ) i ALL OWNED AUTOS(Private Pas) BODILY INJURY ALL OWNED AUTOS (~then Prorate Passengpq HIRED AUTOS PROPERTY DAMAGE S NON-0WNED AUTOS BODILY INJURY 3 GAAAOE LIABIL(TY PROPERTY DAMA" COMBINED s EXCESS UABILITY UMORELLA FORM EACH OCCURRENCE > S OTHER THAN UMBRELLA FORM AGGREGATE 8 tes°IATYYMN uDA MPLOYAIABRJWCV00817000 4/17/2008 4/17/2009 STATUTORY LIMITS EACHACC109W a 100,000 The workers'Compensation olicy does not provide coverage for David H.Nall on. DtSgABe-POLICY UWT : 500,000 DISEASE-EACH EMPLOYEE i 100,000 OTHER DESCRIPTION OF OPERATIONSnACATIUNSAIENIWSISPECiAL ITEMS Attention:Please note that the Insured has not electedd coverage for themselves and there Is no payroll covered on this policy. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE North Andover Town Hall EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Attn:Bld.Dept. IZ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 120 Main St. BUT FAILURE TO MAIL SUCH NOTICE SMALL I POSE NO OBLIGATION OR UABIUTY North Andover,MA 0184$ OF ANY KIND UPON THE COMPANY,ITS AGE)ITS OR FIEPRESENTATIVES. AtrnioRlzED REPRESHNTATIVE 6was t0AI!'AArA qu71TSJIASi7llUft In1^.000i,110 VWJ 7r"n1 0nn'?ra,r,r1i G COn tr In f Bw10 h � U ti0 g Regliat. �icc n Su eri, 'OBS a # 4 ear erase•' C ISO �• hilae S 8 cense. lord kptrati 3/20/ S7g3 DA L//,D ReStrioti Off• 3/2 p� i966 4 CRO N NF On DO .2p0g i' P FRE ST CSONrOr40 0 63"' , C° _�'- >rin�isslO�er�-mac �Oa 7'd°t t311ildin HOME IMPROVEMENT and Srnrlda uae x s i` Registratio oVEMENT CONTRACTOR n -146411 Expiration: 4/22/2009 71 Pe .'DBA Tr* 129945 D.H. NELSON CONSTRUC DAVID NELSON TION 4 CROSS ST PEPPERELL, MA 01463 .p v� Adrninish'atol- CIS I ENTE: N' ORDINE: 578 OPERATGRE: E ti Avi dor Ri f, C(i ente Harsh f i nat DESCRIZIGNE: TIME CILIEGI❑ DATA ORDINE: 18-07--2o08 DATA CGNSEGNA: I8-07-2008 a 60.000—�1 te----60.Ofl0 69.300 le-- -60.000—®i te--60 0 0 n ! .. k � T4i►T031 m .o E54.MAI w O O O T60t+T3 A N UI O W T O O O C E 30 C 00 TC-23430 290Toal 060"31 co z o 90 Q� iT (II p0 co '� O O itni D pt - O cp TC12120 2.0 + o TC01310 00 oa `*'• TC140�T 1 ij CD viro 0 ° > C3 � ocoblai o o TC01220 ; c M � Z[TT03i � Z c V � � ' N p 00 0 0 t _ F