Loading...
HomeMy WebLinkAboutBuilding Permit #270-11 - 29 ANDREW CIRCLE 9/29/2010 Ole o6 rH BUILDING-PERMIT Qc ,6�5 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received � • �''t�rEn Fra �SSACHUSE�. Date Issued: 9 _29- 10 IMPORTANT:Applicant must complete all items on this page _�i:=-:r:'+r�;�-'--- -�`:sre:;y.'.'.xt': -��•:;_�a7t�_=s:a� - _rte = - •:;,: - _ _ Y!. vJ'if', _ ..•�.` _ .:.tin - - - - .:•::••tn� _ t..5 J.. _ - .. .. -.�. 4....,,.,...,..._,.�..:-,..... _ .r_r. .�-..=-t ... -.... ... ...c..._ e--.,,.:5'._...-�C.tip.._- .•-.v -_.,r .x.1-_ .. . ,- ...�•�..I�,.i,.. _:i.� -___ ':r•=:� _ LS'c:'.. •rn.,--- - - .:.r.`.:-z�:�".: ,..u. .-1,-, _ t!s.. r_T: -_ - :J.s .�.._it,=�'-`:�'t•"-��i_.�'r�:::__'_!�=n ..."�'-. _.�=A, _ _ _ _ - '.';_i._.K•=-- - .T,.�..r.-,i_�cvr._4�... c t.u- y� :_C..:� - r• ::v-x_. ..t'.•'r CYC y.:.y, ..n.-> :� :. ='i:. :.i_.-e •.l,J�f _ _ .--.'.1�Y_�.[14e'mow- _ _ _ aAR_ -,E. - - -- - ';�^: �:._.. '•a•"�� t�",- -�4- _ -;pec r Location ,)� No. )�o• I Date v TOWN OF NORTH ANDOVER O 9 Certificate of Occupancy $ Building/Frame Permit Fee $ 1&y0 f s+cMust Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # (� 235L6 14 Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOTZ ublic Sew f wim mm Pools Tanning/Massage/Body Art g Well s ood Packaging/Sales Private(septic tank,etc. mpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM i DATE REJECTED DATE APPROVED .PLANNING &:DEVELOPMENT COMMENTS CONSERVATION Reviewed on Siclriature COIVIIVICIN 10 HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals.`Variance, Petition No: Zoning Decision/receipt submitted yes Pfannfri.r- Board Decision: Comments Conservation Decision: Comments Wafer & Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Os ood Street - .�: w7�;d5•:�k. - - - sae--,; - •,'•=A'- .-:.. _ ,.1'' - f_ ..e:.ii�is-`-.., -lw:_- .�..... rN::.e.....__4.,,:.:.:r...`.v:,._. Ir , i�n - tea. _ : . - +.. _ - - - - - - — - :ii Fr Q - I��rr - - ' wall+:;Y - :Fe - ..-.Y .�, t:��;est• _- _ may.. - ;_?• fes._• _ - 7r^' 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 2010 Building Department The followingis a list of the required forms to be filled out for the ro riate permit to be obtained q PP P 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 o 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) ❑ ivi ORTH TO" of And j7d k M7 )*I (`O LAKE O dower, Mass., I�lep COCKICKEMCK ADRATED PP `�� SS BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .a. t...............1�� �.. .... Foundation has permission to erect.... buildings on ..................................... ...... .........�'�--......4.4....-. Rough to be occupied as �i.f. ..........h ��-�— � -- Chimney p' ......,+........................ provided that the person accept ng this permit shall in every respect co form 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 PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRU STARTS ELECTRICAL INSPECTOR Rough -...�.--................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building 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. Burner. Street No. SEE REVERSE SIDE Smoke Det. Office of Consumer Affairs and usiness Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement CO23traCtor Registration - Registration: 116361 5 Type: Individual .y Expiration: 6/8/2012 Tr# 297248 WAYNE HINCKLEY WAYNE HINCKLEY - 50 FOX AVE. DRACUT, MA 01826 Update Address and return card.Mark reason for change. t_ E] Address D Renewal ❑ Employment Lost Card DPS-CA1 0 50M-041046101216 - - Office�f�oame'�'fa rs `B�sine"sslegalal`io License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: ;9116361 Type: Office of Consumer Affairs and Business Regulation Expiration: 6/8/2012 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 TEHINCKLEY:,�- WAYNE 50 FOX AVE. DRACUT,MA 01826';.' _ Undersecretary Not v without Signa, 4 Massachu+etts-Department of Public Safet% Beard of Building Rej�-ulations and Standards Construction Supervisor License License: CS 32970 ---- r--. Restricted to: 00 ,u WAYNE E HINCKLEY 50 FOX AVE to DRACUT, MA 01826 Expiration: 1/1/2012 (.=e�•reee.•icmrr Tr#: 13586 � a i I The Commonwealth of Massachusetts c F Department of Industrial Accidents �w s!� Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r-� Please Print Le;;ibly Name (Business/Organization/Individual): Al C44 o�� �NG` Address: CS< 43 <oZ 3 City/State/Zip: M K oca A Phone#: 17 9 -eG Z- Are you an employer?Check the appropriate box: Type of project(required): 1.A I am a employer with ti 4. ❑ I am a general contractor and I 6 E]New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. 7 Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9, ❑ Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10T] Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.r] Plumbing repairs or additions myself.[No workers'comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] employees. [No workers' 13.❑ Other comp.insurance required.] *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 acid 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: tqSsac rA rn l til wm iws a+-- 144 Ia&e— Policy#or Self-ins.Lie.#: Expiration Date: /,C/Zol O Job Site Address: 2-9 NlJO, City/State/Zip: N�it�oL- 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. 1 I do hereby certify un PtI pains and penalties of perjury that the information provided above is true and correct Signature: Date: 22 C1 Phone# Official use only. Do not write in this area,to be completed by city or town offrcial. 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 carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pen-nit 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 number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure`that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pennit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future pen-nits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 wwur.mass.gov/dna DATE(MMIDD/YYYY) ACORQ CERTIFICATE OF LIABILITY INSURANCE FM/23/2010 PRODUCER 973.922.2233 FAX 978.922.2731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Appleby & Wyman Insurance Agency Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 152 Conant St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Beverly, MA 01915 INSURERS AFFORDING COVERAGE NAIC# INSURED HINCKLEY BROTHM INC INSURER A: Peerless Insurance Company 24198 P 0 BOX 623 INSURER B: TMSBDBY, MA 01876 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMA'S LTR NSR DATE MM/DD DATE MM/DD GENERAL LIABILITY CCP9840561 08/29/2010 08/29/2011 EACH OCCURRENCE $ 1,000,0001 DA AGE ToRENTEDM COMMERCIAL GENERAL LIABILITY PR ISES Ea Occurrence $ 50,0 CLAIMS MADE ®OCCUR MED EXP(Any one person) $ 5,00 A PERSONAL&ADV INJURY $ 1,000,0 GENERAL AGGREGATE $ 2,000,0 GEN'L AGGREGATE LIMIT APPLES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY jRa LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FI CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNERIEXECUTIVEQ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WALL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of North Andover IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 120 Main Street REPRESENTATIVES. N. Andover, MA 01845 AUTHORIZED REPRESENTATIVE Lisa Marciano/VAL ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PDF created with pdfFactory trial version www.pdffactorv.com IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s)- DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s),authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. i ACORD 25(2009101) PDF created with pdfFactory trial version www.pdffactory.com DATE(MM/DD/YYY) CERTIFICATE OF LIABILITY INSURANCE 09/23/2010 THIS CERTIFI®TE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: I£ the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Appleby 6 Wyman Insurance PHONE FAz Agency Inc (A/c• �. Ez): (A/C. No): E-MAIL 152 Conant Street ADDRESS' PRODUCER Beverly, MA 01915 CUSTOMER IDs. INSURED(S) AFFORDING COVERAGE RAIL� u'iSLA INSURER A: A.I.M. Mutual Insurance Co Hinckley Brothers Inc IHSUABR B: P O Box 623 INSURER C: Tewksbury, MA 01876 INSURER D: INSURER E: INSDRNE F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED HAMM ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREbENT, 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_ LIKITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. sr: TYPE OF INSURANCE POLICY NUMBER PO0EVm/TccT)LICY EFF POLICY EDCP LIMITS GENERAL LIABILITSC CAM oacmtANCE s 00O2Aff.RC—GENERAL LIABILITY DAMAGE T PRENMSES(Eurtena) $ ❑❑CLAI)14 MADE ❑OCCUR HED EIP (Ay— ❑ person) $ F] PERSONAL G ADV INJURY $ RAL GEN'L AGGREGATE LDIIT APPLIES ER: �� A E $ ❑POLICY ❑PRQiECT❑IIIc PRODUCTS-COMP/OP ALG $ AUTOMOBILE LIABILITY ccMNRra®sINCN.E LIMUT (ea accident) $ N.HDIb BODILY IBJURY (pec p—) $ ❑DLI.—.AUTOS ❑SCfD:---AUTOS BODILY INJURY(pec a M.i ) $ ❑HIRED AlJ'tt)S PROPERTY 3PER DAMent) $ (pde�RI ❑NON-aDO:D AUTOS $ $ nUHBREL)A LIAR ❑ OCCUR ��OCCIRZ��E $ �EXCBSS LIAR ❑ CLAINS MADE AGGREGATE $ ❑DEDUCTffiLE $ aRETENTION $ $ WORKERS COEPENSATION AND E2IPLOYE-S LIABILITY saw Lnms THE PROPRIETOR/PARTNERS/ E.L. EACH ACCIDENT $ 100,000 A EXECUTIVE OFFICERS ARE E.L. DISEASE-HA 500,000 ❑ incl ® excl 7023972012009 10/03/2009 10/03/2010 E.L. DISEASE-HA EMPLOYEE 100,000 COMMENTS/DHSCRIPTIOB OF OPERATIONS OR LOCATIONS: STEPHEN P HINCKLEY IS NOT COVERED BY THE WORKERS' COMPENSATION POLICY DAVID H HINCKLEY IS NOT COVERED BY THE WORKERS' COMPENSATION POLICY CERTIFICATE HOLDER CANCELI TION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE 120 MAIN STREET POLICY PROVISIONS. N ANDOVER, MA 01845 ADYRDRIZRRn REPRESENTATIVE ApplebyAVyman Insurance Agency Inc. Since 1903 11/1/2009 Hinckley Brothers Inc. P.O.Box 623 Tewksbury,MA 01876 RE: Worker's Compensation Renewal policy Insurance Co: Associated Industries of MA Mu Policy# AWC7023972012009 Policy period: 10/05/2009 to 10/05/2010 Dear Stephen: Enclosed you will find the above referenced renewal policy. As required by the State of Massachusetts Workers' Compensation laws,this policy provides coverage for your employees for work-related injury or disease. The estimated annual premium is $500.00 and paid in full. The premium has been calculated using the estimated payroll information below. The company will complete a final audit and premium calculation at the end of the policy period. Classifications Payroll Carpentry If Any Employers' Liability coverage is included subject to the following limits: Bodily Injury by Accident $100,000 Each Accident Bodily Injury by Disease $500,000 Policy Limit Bodily Injury by Disease $100,000 Each Employee Higher limits of liability may be available. Please advise if you would like a quote. Please read your policy to be familiar with its exact coverages,conditions, limitations,and exclusions. In the event of a claim,we recommend that you contact the company directly. The claims reporting number is: 1-800-876-2765. If you have any questions please call our office. Thank you for your business. Sincerely, Stephanie M.Murphy Appleby& Wyman Insurance Agency,Inc. 152 Conant Street,Beverly,MA 01915 TEL 978-922-2288 FAX 978-922-2731 858 Washington Street,Suite 104,Dedham,MA 02026 TEL 781-329-5420 FAX 781-329-8861 234 Littleton Road,Suite IF, P.O.Box 330,Westford,MA 01886 TEL 978-692-3330 FAX 978-692-0728 www.applebywyman.com GENERAL CONTRACTORIHOME OWNER AGREEMENT THIS AGREEMENT IS ENTERED INTO THIS DAY OF SEPTEMBER, 2010, BY AND BETWEEN Robert J. Duffy and Elizabeth E. Duffy, (hereinafter"Home Owner") of P. O. Box 221, 57 Paine Avenue,Prides Crossing,MA 01965 and Hinckley Brothers Inc.,a Massachusetts corporation(hereinafter"General Contractor") of P. O. Box 623 Tewksbury Ma 01826 PROJECT PREMISES: 29 Anne Road,North Andover. Title Reference: Deed recorded with the Essex North Registry of Deeds in Book 6261 Page 219. DESCRIPTION OF GENERAL CONTRACTING SERVICES: The General Contractor shall provide the Home Owner with the following general contracting services: 1. To oversee the restoration of the premises (hereinafter the"Project Premises")identified as 29 Anne Road N.Andover, MA. The General Contractor will secure all necessary Sub-contractors and will assist in the finalization of contracts between the Sb-contractors and the General Contractor; Na•�^_ Ow n 2. It is understood that the General Contractor will not personally undertake the construction of any component or system within the Project Premises but that same shall be undertaken by various Sub- contractors. In the event the General Contractor proposes to perform any labor services relevant to any phase of construction, then the General Contractor and the Home Owner shall enter into a separate written agreement defining the scope of said services and the cost for same. 3. Upon final completion of construction of Project Premises the General Contractor will apply for and obtain an occupancy permit from the Town of N.Andover,MA. The services described in the Terms and Conditions attached hereto. iT TIME FOR STARTING AND COMPLETING PROJECT: WORK SHALL COMMENCE WITHIN TEN DAYS AFTER THE LAST TO OCCUR OF THE FOLLOWING: (1)Receipt by the General Contractor of all necessary building permits; (2) Home Owner has complied with all Terms and Conditions of the Agreement to date; (3) Receipt from the Home Owner of written confirmation of construction funds in the amount of$XXXXXX under the control of the Home Owner to complete all phases of the Project. i GENERAL CONTRACTOR'S PAYMENT: i Home Owner agrees to pay General Contractor as full compensation for the services contemplated by this agreement(1)a total cash price of Thirty Thousand Dollars ($30,000.00); and(2)Fifty Percent 50% of the total profits upon sale of home("Total Profit"). Such Total Profit is to be determined as follows: Sale price of Home Less: Closing costs paid by Owner/Seller at closing Basis of existing Home: $550,000.00 Construction costs paid by Owner, including costs of General Contractor, Sub- contractors and suppliers,permitting costs, and like expenses, Operating expenses and listing expenses paid by owner from contract date to sale date, including electricity, natural gas, lawn maintenance, landscaping and snow removal expenses, cleaning, and staging. Equals Total Profit,of which 50%is to be paid to General Contractor. Payment of the General Contractor's fee shall be in installments as follows: 1St Installment of$10,000.00 to be made prior to commencement of work on the Project; 2"d Installment of$10,000.00 to be made upon completion of wallboard P Installment of$10,000.00 to be made upon receipt of certificate of occupancy All payments will be sent by Home Owner via first class mail within five(5)business days after billing statement is received by Home Owner. If any payment is not received within ten(10)days after a statement has been received by Home Owner, General Contractor may keep the job idle until such time as all payments 2 �� due under such outstanding billing statement(s) has been made. A failure of payment for a period in excess of said five(5)business days shall be considered a major breach. Funds will be paid directly by the Home Owner to the General Contractor as well as to all Sub-contractors after General Contractor provides to Home Owner "Sub-Contractor Payment Request." Sub-contractor Payment Request shall include (i) written approval by General Contractor of invoices received from Sub-contractors indicating that General Contractor has inspected the work included in such invoices, the work has been completed in a workmanlike manner and meets the quality standards for the project reviewed and approved by General Contractor and Home Owner; (ii) a comparison of invoices received from Sub-contractors to budget prepared by General Contractor for such; and (iii) summary of cost to complete for remaining work to be completed by such Sub-contractor for which invoice is being rendered. To the extent not covered by a mechanics lien bond for the Project, General Contractor shall secure and promptly deliver to Home Owner upon receipt of all payments to General Contractor and Sub-Contractors and suppliers a partial lien waiver,in a form acceptable to Home Owner. NOTICE TO THE HOME OWNER (1)Do not sign this Agreement before you read it or if it contains any blank spaces. (2) You are entitled to a completely filled in copy of this Agreement. Home Owner acknowledges that he/she has read and received a legible copy of this Agreement signed by General Contractor, including all Terms and Conditions herein included, before any work was done. If Home Owner cancels this Agreement after the right of recession has expired, and before commencement of construction, Home Owner shall pay General Contractor the amount of any expenses incurred to that date. TERMS AND CONDITIONS The Terms and Conditions appended hereto are expressly incorporated into this Agreement. This Agreement constitutes the entire understanding of the parties. No other understanding or representations, verbal or otherwise, shall be binding unless in writing and signed by both parties. This Agreement shall not become effective or binding upon General Contractor until signed by General Contractor. By Home Owner's signature below, Home Owner acknowledges receipt of a fully completed copy of the Agreement. HOME O R: Robert J.Duffy DATE 3 i HOME OWNER: Elizabeth E. Duffy DATE PH: Email: GgNtRAL CONTRACTOR DATE inckley Brothers Inc. 1021 Shawsheen Street Tewksbury,MA 01876 Stephen P. Hinckley,Treasurer MA Builder's License PH: 978-852-6364 Email: hinckleybrosinc@gmail.com TERMS AND CONDITIONS HAZARDOUS MATERIALS Home Owner represents that, to the best of Home Owner's knowledge, the property does not contain hazardous materials. This contract does not contemplate the testing for or removal of hazardous materials. GENERAL CONTRACTOR'S RIGHTS AND RESPONSIBILITIES 1. General Contractor shall have the right to stop work and keep the job idle if subcontractors' payments are not made when due. Failure to make payment within ten (10) business days of the date Sub-Contractor Payment Request prepared and approved by General Contractor has been received by Home Owner will be considered a material breach of this Agreement. If the work shall be stopped for any reason for a period of sixty (60) days, then General Contractor may, at General Contractor's option, upon five (5) business day's written notice, demand and receive payment for the General Contractor's fee based upon the contract price. Thereafter, General Contractor is relieved from any further liability. In the event of work stoppage for any reason, General Contractor shall secure the work site and direct all Sub-Contractors to secure their tools, equipment and materials. Home Owner shall be responsible for the reasonable cost of providing special or extra protection for materials on the premises. 4 P0q 5� 2. General Contractor, after consultation and approval by Home Owner, , may alter construction specifications but only so as to comply with requirements of governmental agencies having jurisdiction over same. 3.All work shall be completed in a workmanlike manner and in compliance with all building codes and other applicable laws. 4. To the extent required by law, all work shall be performed by individuals duly and currently licensed and authorized by law to perform said work. All Sub-Contractors shall have current commercial general liability insurance with commercially reasonable limits and shall have current workers compensation insurance covering all persons performing labor for any Sub-Contractor on the premises 5. General Contractor agrees to assist Home Owner in procuring all materials necessary to complete the Project and to oversee completion of the Project in a professional manner. 6. LIMITED WARRANTIES: General Contractor will require all Sub-contractors as part of their contracts with the Home Owner to certify that the specified work being contracted for will be performed in a substantial and workmanlike manner according to standard practices prevalent in their trade and further that: (1)the specified work will comply with all applicable building codes and regulations. (2) the labor and materials provided as part of the specified work will be free from defects for a period of one (1) year from the date of completion. It is understood and agreed that the primary purpose of this project is to prepare the premises for sale and, as such, this limited warranty extends to the Home Owner and any purchaser of the property from the Sub-contractors.. There is no implied warranty either expressed or implied, nor any implied warranty of fitness for any particular purpose to be granted to the Home Owner by the General Contractor. All equipment, assemblies, or units purchased by the Home Owner, are sold and installed subject to the manufacturer's or processor's guarantee or warranties, and not that of the General Contractor's. To the extent permitted by applicable law, all warranties given by manufacturers pertaining to materials used by General Contractor in connection with the Project will be passed through and inure to the benefit of Home Owner and any buyer of the property. 7. The Home Owner shall pay all sub-contractors, laborers and material suppliers in a timely manner so as to keep Home Owner's property free of valid labor, material or mechanic's liens. 8. The General Contractor will provide construction supervision services using duly licensed professionalswill visit the site at least once each day work is being performed. General Con for shall be the primary point of contact for all Sub- Contractors and suppliers on 1 issues related to the project. Q� 5 " I 9. General Contractor and Home Owner shall meet at the premises or another agreed-upon location at least once every 14 days to review project progress and next steps, adherence to budget and schedule, review any schedule updates,review any design issues or changes,and address any other issues related to the project. 10. General Contract has prepared an estimated week-by- construction schedule through completion,which is attached as Exhibit A and incorporated herein by reference. General Contractor shall revise and update the schedule prior to each meeting with Home Owner to indicate progress and time remaining. General Contractor shall immediately advise Home Owner of any known or suspected causes of significant delay. General Contractor bears primary responsibility for managing the construction progress, scheduling and managing Sub-Contractors and suppliers, and supervising Sub- Contractors and suppliers to keep the project as close to the agreed-upon schedule as is commercially reasonable, subject to Paragraph 2 below. 11. General Contractor has prepared a project budget, attached as Exhibit B and incorporated herein by reference. General Contractor shall revise and update the budget and deliver same to Home Owner with each Sub-Contractor Payment Request. General Contractor shall immediately advise Home Owner of any known or suspected causes of significant budget changes. ITEMS NOT THE RESPONSIBILITY OF GENERAL CONTRACTOR 1. EXISTING VIOLATIONS AND CONDITIONS. General Contractor shall not be held responsible for any existing violations of applicable building regulations or ordinances, whether cited by the appropriate authority or not. General Contractor is not responsible for any abnormal or unusual preexisting conditions or any unusual or abnormal concrete footings, foundations, retaining walls, framing, roofing or other components of the Project Premises. Correction of such violations or abnormal conditions which may need to be corrected by the General Contractor shall be considered additional work and shall be dealt with as herein provided for under"Extra Work". 2. DELAYS. General Contractor agrees to start and diligently pursue work through to completion,but shall not be responsible for delays for any of the following reasons: (a) failure of the issuance of all necessary building permits within a reasonable length of time; (b)construction funding or disbursement of construction funds by the Home Owner or Home Owners employees or Home Owners agent;(c)acts of God,fire,extreme stress of weather, strikes, lockouts,boycotts, or other labor union activities,extra work ordered by Home Owner, acts of the public enemy, riots or civil commotion,inability to secure material through regular recognized channels, imposition of government priority or allocation of materials;(d) failure of Home Owner to make payments when due as provided in this agreement; (e)delays caused by inspection or changes ordered by the inspectors of authorized governmental bodies; (f)holidays; or(g) or other causes beyond General Contractor's reasonable control. For purposes of this agreement,other project commitments of the General Contractor and coordination of Sub-contractor and supplier schedules are deemed to be within the control of the General Contractor. HOME OWNER'S RESPONSIBILITIES UTILITIES: The Home Owner is responsible for water, gas, sewer and electric utilities, from the appropriate agency to the metering devices servicing the Project Premises. It is the Home Owner's responsibility, at Home Owner's expense, to provide toilet facilities, electricity and water to the site as needed by the Sub-contractors working on the Project. FINANCING: The Home Owner is responsible for having sufficient funds to comply with this Agreement. This is a cash transaction. INSURANCE: Home Owner will provide General Contractor a copy of current insurance and General Contractor shall confirm acceptance of such insurance prior to commencement of the project and any fee due to General Contractor. The General Contractor shall verify that all Sub-contractors retained to perform any work on the Project Premises have the required workman's compensation insurance for themselves and their employees or agents. DAMAGE OR DESTRUCTION: If the Project or any portion of it is destroyed or damaged by fire, storm, flood, landslide, earthquake, theft, or other disaster or accidents, any work done by the General Contractor to rebuild, etc., shall be paid for by Home Owner as an Extra and dealt with as herein provided for under"Extra Work". BOUNDRY LINES: The Home Owner represents Home Ownership of the property where construction is to occur. It is the Home Owner's duty to confirm the location of boundary lines of the property and Home Owner is responsible for the accuracy of such lines and how they are represented on drawings. If required, the Home Owner will pay for a survey to chart boundary lines. j I ENGINEERING AND GEOLOGY: Unless specifically agreed upon in writing between Home Owner and General Contractor, and made a part of this Agreement under "Description of Materials", "Specifications" or"Plans", this Agreement does not include any engineering or geology surveys, drawings, studies, reports or calculations as may be required by a public body or building authority as a condition for issuance of a building permit or as a condition to securing final building inspection. The cost of any such required professional services shall be paid by Home Owner. I DRAWINGS AND SPECIFICATIONS: The Project will be constructed according to drawings and specifications that have been examined by Home Owner and that have been or may be signed by the parties to this contract. Unless otherwise specifically provided the Home Owner will obtain and pay for all required building permits. Home Owner will pay any assessments and charges required by public bodies and utilities for financing or 7 tl� I I repaying the cost of sewers, storm drains, water service, or other utilities including sewer and storm drain reimbursement charges, use fees, revolving fund charges, hookup charges and the like. MEASUREMENTS: Measurements, sizes and shapes in plans and specifications are approximate and subject to field verification. Unless otherwise specified, all dimensions are exterior dimensions. In the event of a conflict between the plans, specifications, etc., and the Agreement, this Agreement is controlling. General Contractor is not responsible for any existing illegal conditions. MATERIAL REMOVED AND DEBRIS: It shall be the responsibility of the General Contractor to ensure that each Sub-contractor removes construction debris no less frequently than Friday at 5PM and to leave premises in a neat broom-clean condition at the end of their job. ADDITIONAL REQUIREMENTS FOR COMPLETION: General Contractor shall promptly notify Home Owner of any additional requirements necessary to facilitate the Project's completion. Any subsequent amendment, modification or agreement, which operates to alter this contract, and which is signed or initialed by General Contractor and Home Owner, shall be deemed a part of this contract and shall be controlling in case of conflict, to the extent that it alters this contract. EXTRA WORK: The Home Owner and General Contractor must agree in writing to any modification or addition to the work covered by this contract. The General Contractor shall do no extra work without the written authorization of the Home Owner. Any written agreement shall list the agreed terms and be signed by both parties. DISPUTE RESOLUTION: All disputes hereunder shall be resolved by binding arbitration in accordance with the rules of the American Arbitration Association. The decision of the arbitrator shall be final. Disputes shall be settled according to the laws of the state that apply to this agreement. Any costs and fees (other than attorney fees) associated with mediation and arbitration shall be shared equally by the parties. Each party shall pay his or her own attorney fees associated with arbitration or litigation. GENERAL: This contract, including incorporated documents, constitutes the entire agreement of the parties.No other oral or written agreements between General Contractor and Home Owner,regarding construction to be performed exist. This agreement shall be construed in accordance with, and governed by, the laws of the Commonwealth of Massachusetts. NOTICE: Any notice required or permitted under this contract may be given by ordinary mail sent to the address of either the Home Owner or General Contractor as listed in this contract, but the address may be changed by written notice from one party to the other. 8 j Notice is considered received five (5) days after deposited in the mail, postage paid. The parties may agree on any other acceptable form or manner of giving notice. 9