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HomeMy WebLinkAboutBuilding Permit #963-16 - 35 SANDRA LANE 3/10/2016LP BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No# -9 �3,- (V Date Received Date Issued: /(0 1/07 'IMPORTANT: A-DDlicant must complete all items on this page LOCATION -3�5 SCXCOQX LCT)e— .. �nnt PROPERTY WNER Vnb De(-N(NeL-? Print MAP PARCEL: 4-'Z ZONING DISTRICT 0 *0 Year Structure yes C no Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building El One family El Addition El Two or more family 0 Industrial 0 Alteration No. of units: El Commercial p4lRepair, replacement 0 Assessory Bldg 0 Others: [I Demolition D Other TEN Fe—bd * W,,,:e I =,7, MT, gf, QC, 7 DESCRIPTION OF WORK TO BE PERFORMED" r -4A C�.� I It, q(\e.�s �b a-%ocVoc�- 3�� -,Y� sz,� Joor \act--> co;K,\ Identification - Please Type or Print Clearly 4t OWNER:. Name: Phone: Contractor Name: News 'JE - 5;�\/ k CP -3 Phone: -AN -760 203( Email: #Y-\cL(,k 0� com Address: P0. Z" 2—R2—S IAO')o�r,�f M8 0 \?S? Supervisor's Construction License: C5 P' -)3q91 Exp. Date: Home Improvement License: 12 9 i-7�7 Exp. Date: �7 ARCH ITECT/ENGI NEER K \ �.A Phone: Address: Reg. No. FEE SCHEDULE. BULDING PERMIT. MOO PER $1000.00 OF THE TOTAL ESTIMATED COSTBASQ—,Q& $125.00 PER S.F. Total Project Cost: $ ;-16. cx +L4�. FEE: $ !;�& 57(e,— r,' 6 /Zil 000' 1 -r Check No.: WK� 701 --,\ Receipt No.: NOTE: Persons contracting wit4 i(nregiste�edcptquctors do not have � lo' rheguarantyfund At L� Plans Submitted [I Plans Waived [I Certified Plot Plan [I Stamped Plans 11 TYPE OF SEWERAGE DISPOSAL Public Sewer El Tanning/MassagelBody Art Swimming Pools Well Tobacco Sales Food Packaging/Sales 11 Private (septic tank, etc. Permanent Dumpster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE, ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoninb Decision/recelpt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer ConnectionlSignature & Date DrivewaV Permit DPW Town Engineer: Signature: 'Located 384 Osgood Street Jp :1 gpi ster,:onk�itb,4,,��" RN *'kjT,,e'-rFn ;'M A RiTiMEN St t qLfocafeaMt 1- -41 XaMn bireer 54 j1e.1 at ntg�e RM Ne/Nat e --p nat r �T " �W 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 MGL Chapter 166 Section 21A —F and G min.$10041 000 fine NOTES and DATA — (For department use 11i'm I LJ Notified for pickup Call I Email I Date Time Contact Name Doc.Building Pemit Revised 2014 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 4� Building Permit Application 4� Workers Comp Affidavit 4. 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 OTE: 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/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) 4� Mass check Energy Compliance Report (if Applicable) ,& Engineering Affidavits for Engineered products . OTE: 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 2012 IECC Energy code Engineering Affidavits for Engineered products IOTE: 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 Doe: Building Permit Revised 2014 Location No. 1?61 � —)roe D ate �, "S 1/0/� �/j JI - t p (- Check # ��!5 .0 30112 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $__w TOTAL $ Building Inspector Enter construction cost for fee cal - North Andover Fee Cakulation Construction Cost $ 43�000.00 m $ - $ 516.00 Plumbing Fee $ 64.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 64.50 Total fees collected $ 745.00 35 Sandra Lane 963-2016 on 3/10/2016 Remodel Kitchen FW..4lum LU LL 0 0 co 0) 0 0 L E a) >. Ln a a) (A 0 u 4A z Q z co .2 0 LL. bD :3 0 W cu c E U Ll- 0 LLI z z co -a W =3 o L.L LUU z LU = to 0 u V) LL 0 u z (A to D o cf: LL z LLJ LLI 0 LU LL r_ =j co 6 z Q) a) Ln cc o CA cc CD 2 0, w C.) E 4) CL U) E Lm r 0 . li CL U) CD > cn 0 > 0 0 AE ch E 0 0 z CL U) w 0 r— P = CL. 0) A mo 41 U) tm cro—a 20.0 -0 cc 40 W 0 0 .2 w r w U) CLM Llr- LLI E 0 cn (D -5; U) !E U) _a Lo r - o L- 0 4w# = 0 L) 0 ui CL U) Z E Cl) cn 0 > cn CL x 0 LLJ 0 0 Cl) Cl) LLI LLJ -j CL 0 C 0 N 0 m 0 0 0 0-71 �6) 0 E 0 z 0 E 0 cc CL U) 0 .2 CL U) 0 CL U) w I . 0 vo-a U 4) CL U) c CF) c 0 — :2 0 Cc mo L- " 0 CL CL —J 0 cl) CL d 1k Nexus 11 Carpentry and Construction Design P.O. Box 2823 Wobum, MA 01888 7817602031 Fax 978 975 1263 nexuscaryentry(&aoI.com C61itiract4r- t Page 1 of 4 A This is a contract between Robert and Kimberly Denney of35 Sandra Lane, North Andover MA 01845 (Hereafter referred to as the "owners") and Nexus 11 Services (hereafter referred to as "Nexus") dated February 8112016. GENERAL SCOPE OF WORK DESCRIPTION WE HEREBY SUBMIT SPECIFICATIONS AND CONTRACT FOR: work as stated to repair water damages as below Scope of work: General details Meet with local building official and apply for permits All work will be in accordance with local building code regulations and will be inspected by local officials prior to continuing with the next phase — Nexus will be responsible for arranging and being available for all inspections Nexus will contact "Dig Safe" prior to commencing any excavation work for their clearance All work will be coordinated directly between "owners" and Nexus * Nexus confirms that it is fully licensed, insured and ensures any sub -contractors utilized on this site will have the appropriate insurance coverage # Nexus will be responsible for the safe storage of all its property and any materials to be used on the site * Owner is responsible for removal and return of all items of the house in the areas that will be affected and their safe storage prior to our work commencing * Owner will then be responsible for returning all items to these areas of the home after completion of the scope of work SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND PROJECT MANAGEMENT AV -A . Page 2 of 4 Remove and trash into Nexus supplied dumpster all trash associated with this project NOTE: appliances are not allowed to be put in durapsters without additional costs 4�owners" are responsible for removal from site Scope of Work Kitchen water damage repairs; * Provide dumpster to remove debris associated with this scope of work + Furnish and install plastic protection to provide dust control * Remove and trash existing "discovered" hardwood flooring * Remove and trash existing wall cabinets * Detach existing refrigerator and stove * Furnish and install updated plumbing lines for sink.. faucet, dishwasher and water feed to refrigerator * Furnish and install updated electrical connections * Furnish and install insulation to exposed exterior wall and to ceiling of basement laundry room * Furnish and install patched sheetrock with smooth plaster finish to walls only - * Install kitchen base and wall cabinets, construct island and associated trim details (supplied by owners and not included in this cost proposal) * Furriish and install hardwood flooring to patch to remaining hardwood flooring * Sand existing hardwood flooring existing and new hardwood flooring in kitchen and eat in area only + Furnish and install 3 coats of polyurethane to existing and new hardwood flooring in kitchen and eat in area only 4 Furnish and install paint grade baseboard trim * Install sink and faucet (supplied by owner and not included in this proposal) * Furnish and paint the 4 walls of the kitchen and eat in area + Furnish and paint the ceiling of the kitchen and eat in area * NOTE: no trim painting included * Furnish and install new suspended ceiling tile in laundry room * Install appliances and fixtures supplied by owners * Proposed cost including materials and labor as noted above is - Work not included in this contract — Building department fees — Engineering or architect costs — Permit costs — Unseen conditions — Cabinets or counters — Painting or staining work not specifically noted in the above scope of work — Appliances, sinks, faucets or fixtures — Servpro, asbestos or any demolition costs previously invoiced — Utility upgrades, changes to existing layouts, lighting changes — Any other work not specifically noted above SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND PROJECT MANAGEMENT Page 3 of 4 PERMITS "Nexus" will accept responsibility to obtain the necessary building permits. "Nexus7 will act as a GC and work in accordance with fair and reasonable practices, and cooperate fully and under the guidance of the "Owners" and authorized parties. Nexus will pass the cost of the permit directly on to the"Owners" once advised by the Building department. Standard Exclusions: Unless specifically included in the "General Scope of Work7 section above, this agreement does not include labor or materials for the following work (any Exclusions in this paragraph which have been lined out and initialed by the parties do not apply to this Agreement): Removal and disposal of any materials containing asbestos or any other hazardous material as defined by the EPA. Custom milling of any wood for use in project. Moving "Owners�" property around the site. Labor or materials required repairing or replacing any "Owners" - supplied materials. Repair of concealed underground utilities not located on prints or physically staked out by "Owners", which are damaged during construction. Surveying that may be required to establish accurate property boundaries for setback purposes (fences and old stakes may not be located on actual property lines). Final construction cleaning ("Nex&' will leave site in "broornswept"condition). Landscaping and irrigation work of any kind. Temporary sanitation, power, or fencing. Removal of soils under house in order to obtain 18 inches (or code -required height) of clear space between bottom of joists and soil. Removal of filled ground or rock or any other materials not removable by ordinary hand tools (unless heavy equipment is specified in scope of work section above), correction of existing out -of -plumb or out -of -level conditions in existing structure. Correction of concealed substandard framing. Removal and replacement of existing rot or insect infestation. Construction of a continuously level foundation around structure (if lot is sloped more than 6 inches from front to back or side to side, "Nexus" step the foundation in accordance with the slope of the lot). Exact matching of existing finishes. Repair of damage to roadways, sidewalks, or driveways that could occur when construction equipment and vehicles are being used in the normal course of construction. The '­OwneC' is to enter into contracts for all of the above-mentioned services and provide direct payment to "Nexus7' for all of the services we are to provide. "Nexus7' will be responsible for removing all components and all construction materials relevant to the "scope of work" in this contract. The "Owners" have received a copy of the lead hazard information pamphlet informing them of the potential risk of the lead hazard exposure from renovation activity to be performed in the dwelling unit. This was received before the work began and the "owners" are responsible for informing their tenants of all potential hazards. Dumpsters, trailers and signs "Nexus" will provide as included in the cost of this project a dumpster for the sole purpose of the removal of trash associated with this project. This dumpster should not be used by any persons for any other waste items or for any purpose outside of the specific use under the scope of work, unless authorization is received from "Nexus"_ Nexus may have on site for part, or the whole of the project, a trailer containing materials and tools belonging to "Nexus". This trailer will be parked in a position agreed to in coordination with the "Owners" and will be covered under the insurances of "Nex&' at all times. "Nexus" will have on site, a sign, with our contact details, in the event that anyone has a need to contact us directly. Photogr phs "Nexus" reserves the right to, from time to time, take photographs of the contracted work for use in its general marketing or for production on its web site. At no time will "Nexus" share any personal contact details of the "owner" for any photographs that it may use without seeking authorization from the "ownee'. Warranties All the components supplied by "Nexus" as part of the original order are covered under the warranty exercised by "Nexus" and supported by the vendors. All labor and materials purchased from other suppliers to achieve completion of contract are warranted (1) one year from completion of the construction. Expiration of this Agreement: This Agreement will expire 30 days after the date at the top of page one of this agreement if not accepted in writing by ;'Owners�' and returned to "Nexus" along with the necessary deposits within that time frame. Changes in the Work: During the course of the project, "Owners" may order changes in the work (both additions and deletions). "Nexus" will determine the cost of these changes and the cost of this additional work will be added to "Nexus" profit and overhead. SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND PROJECT MANAGEMENT People Authorized to Sign Change Orders: The following peoVjq are authorized to sign Change Orders: White Kimbierley Page 4 of 4 Concealed Conditions: This Agreement is based solely on the observations "Nexus" was able to make with the area in its current condition at the time this Agreement was bid. If additional Concealed Conditions are discovered once work has commenced which were not visible at the time this proposal was bid, "Nexus" will stop work and point out these unforeseen Concealed Conditions to "Owners" so that "Owners" and "'Nexus" can execute a Change Order for any Additional Work. Schedule of work it is agreed by both parties that this work will be coordinated with the"Owners" and "Nexus" to be undertaken in various stages to avoid complete disruption of the home environment. "Nexus" will give "Owners" no less than 2 days notice prior to arriving on site for commencement of any of the agreed stages of work to allow "Owners" to prepare. "Owners" commits to have sites identified for construction work available for start at the beginning of the scheduled day so as to avoid any unnecessary delays. Contract Cost and Payment Schedule: Total cost of work description and materials included in the proposal (except materials/work stated) - S 11, 454.16 (Eleven thousand four hundred and fifty four dollars and sixteen cents) PAYMENT SCHEDULE 1st Payment due upon signing this contract TOTAL $3, 820.16 2nd Payment due upon Installation of kitchen cabinets TOTAL $3, 820.00 Final payment due upon completion of scope of work TOTAL $3, 814.00 Amount due upon signing this contract - $3, 820.1 I have read and understand, and I agree to, all the terms and conditions contained in the- proposalabove. Date .... ..... . "Nexus" Date .... 3-,- �- -(V ..... .. Client" Date ............................... . Client" Authorization ...................................................... SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND PROJECT MANAGEMENT 14 90-20 3T ff ;r�-2 3 0" -24�' wt U278424SS U248424,'EF3.,�-' f -23 FDOPM — ------------- KI LL W T cq tn t4 LL co 0 LL ce).... :�j :-7 00 f. V. C%j Ul) Go sees, UIZA MOZZWEAAd (mn CV HOCPZZ) 83 VY:D MOCCCAA V93M23-CIF-AA To-mcm CV IL, c Lu 40 — ----- Z4– ZL- -qs-. i a7 i I '�p /01 lz�, 0 1 :k Page I of 4 I I t Nexus 11 Carpentry and Construction Design P.O. Box 2823 Woburn, MA 0 1888 7817602031 Fax 978 975 1263 C>r neXUSCarpentr,V(d,)ao1.com Cbntf 112" This is a contract between Robert and Kimberly Denney of 35 Sandra Lane, North Andover MA 01845 (Hereafter referred to as the "owners") and Nexus H Services (hereafter referred to as "Nexus") dated March 8" 2016. GENERAL SCOPE OF WORK DESCRIPTION HEREBY SUBMIT SPECIFICATIONS AND CONTRACT FOR: work as stated for 6- * Meet with local building official and apply for permits * All work will be in accordance with local building code regulations and will be inspected by local officials prior to continuing with the next phase — Nexus will be responsible for arranging and being available for all inspections * Nexus will contact "Dig Safe" prior to commencing any excavation work for their clearance * All work will be coordinated directly between "owners" and Nexus * Nexus confirms that it is fully licensed, insured and ensures any sub -contractors utilized on this site will have the appropriate 'insurance coverage * Nexus will be responsible for the safe storage of all its property and any materials to be used on the site * Owner is responsible for removal and return of all items of the house in the areas that will be affected and their safe storage prior to our work commencing * Owner will then be responsible for returning all items to these areas of the home after completion of the scope of work * Remove and trash into Nexus supplied dumpster all trash associated with this project NOTE: appliances are not allowed to be put in dumpsters without additional costs "owners" are responsible for removal from site SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND PROJECT MANAGEMENT 'S Page 2 of 4 of * Provide duinpster to remove debris associated with this scope of work * Remove and SAVE existing rear entry door NOTE: door to be given to Ray # Frame this opening in preparation for new sheetrock and siding 4 Remove and trash the existing rear facing window + Remove and re -work existing baseboard heat pipes to allow for installation of a 6' 0" Andersen 200 Permashleld sliding patio door * Remove and trash framing in this area to create rough opening dimension for the new 60" x 6' 8" Andersen 200 Permashield sliding patio door * Furnish and install new 60" x 68" Andersen 200 Permashield sliding patio door - prefmished white on the interior and exterior and with "satin nickel" hardware. * Furnish and install insulation into this rear wall * Remove and trasb existing kitchen ceiling and the ceiling of the "eat -in" area * Remove and trash existing hardwood flooring in the kitchen area only - NOTE: Leave flooring in "eat in" area C� * Furnish and install electrics to code inclusive of island outlets, 2 - pendants (supplied by owne ' r) over new island, I ceiling fixture over potential table by bay window. up to 6 recessed cans in the kitchen area and I exterior wall sconce outside new sliding patio 'door 4 Furnish and install 2 kick space heaters fed from the existing floor zone (NOTE: I heater under kitchen sink -and I under new window seat area) * Furnish and install sheetrock with smooth plaster finish to exposed framing of walls and ceiling * Install additional cabinets to kitchen layout NOTE: cabinets provided by "owners" * Install "Bay window" cabinetry and window seat provided by "oxvners" (NOTE: all materials are expected to arrive pre -finished and ready to be installed) * Furnish and install new hardwood flooring to blend into existing flooring * Sand entire hardwood flooring in kitchen and "eat in" area + Furnish and install 3 coats of polyurethane to this floor only (NOTE: no other floor areas to be included at this time) # Fu i mish and install paint grade trim to new door, window and baseboard and to match to the existing style in the home, as closely as possible o Painting as includedin contract #1- walls, ceiling and trim in kitchen/eat in area — Work not included in this contract — Building department fees — Engineering or architect costs — Permit costs — Unseen conditions — Kitchen window change nor its installation ($920.00 previously quoted being materials cost + $200.00 labor cost) — Cabinets or counters — Painting or staining work not specifically noted in the above scope of work — Appliances, sinks, faucets or fixtures — Utility upgrades, changes to existing layouts, lighting changes — Any other work not specifically noted above SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND PROJECT MANAGEMENT Page 3 of 4 PERMITS "Nexus" will accept responsibility to obtain the necessary building permits. "Nexus" will act as a GC and work in accordance with fair and reasonable practices, and cooperate fully and under the guidance of the "Owners" and authorized parties. Nexus will pass the cost of the permit directly on to the "Owners" once advised by the Building department. Standard Exclusions: Unless specifically included in the "General Scope of Work" section above, this agreement does not include labor or materials for the following work (any Exclusions in this paragraph which have been lined out and initialed by the parties do not apply to this Agreement): Removal and disposal of any materials containing asbestos or any other hazardous material as defined by the EPA. Custom milling of any wood for use in project. Moving "Owners" property around the site. Labor or materials required repairing or replacing any "Owners" - supplied materials. Repair of concealed underground utilities not located on prints or physically staked out by "Owners", which are damaged during construction. Surveying that may be required to establish accurate property boundaries for setback purposes (fences and old stakes may not be located on actual property lines). Final construction cleaning ("Nexus" will leave site in "broom swept" condition). Landscaping and irrigation work of any kind. Temporary sanitation, power, or fencing. Removal of soils under house in order to obtain 18 inches (or code -required height) of clear space between bottom of joists and soil. Removal of filled ground or rock or any other materials not removable by ordinary hand tools (unless heavy equipment is specified in scope of work section above), correction of existing out -of -plumb or out -of -level conditions in existing structure. Correction of concealed substandard framing. Removal and replacement of existing rot or insect infestation. Construction of a continuously level foundation around structure (if lot is sloped more than 6 inches from front to back or side to side, "Nexus" step the foundation in accordance with the slope of the lot). Exact matching of existing finishes. Repair of damage to roadways, sidewalks, or driveways that could occur when construction equipment and vehicles are being used in the normal course of construction. The "Owner" is to enter into contracts for all of the above-mentioned services and provide direct payment to "Nexus" for all of the services we are to provide. "Nexus" will be responsible for removing all components and all construction materials relevant to the "scope of work" in this contract. The "Owners" have received a copy of the lead hazard information pamphlet informing them of the potential risk of the lead hazard exposure from renovation activity to be performed in the dwelling unit. This was received before the work began and the "owners" are responsible for informing their tenants of all potential hazards. Dumpsters, trailers and signs "Nexus" will provide as included in the cost of this project, a dumpster for the sole purpose of the removal of trash associated with this project. This dumpster should not be used by any persons for any other waste items or for any purpose outside of the specific use under the scope of work, unless authorization is received from "Nexus". Nexus may have on site for part, or the whole of the project, a trailer containing materials and tools belonging to "Nexus". This trailer will be parked in a position agreed to in coordination with the "Owners" and will be covered under the insurances of "Nexus" at all times. "Nexus" will have on site, a sign, with our contact details, in the event that anyone has a need to contact us directly. Photographs "Nexus" reserves the right to, from time to time, take photographs of the contracted work for use in its general marketing or for production on its web site. At no time will "Nexus" share any personal contact details of the "owner" for any photographs that it may use without seeking authorization from the "owner". Warranties All the components supplied by "Nexus" as part of the original order are covered under the warranty exercised by "Nexus" and supported by the vendors. All labor and materials purchased from other suppliers to achieve completion of contract are warranted (1) one year from completion of the construction. Expiration of this Agreement: This Agreement will expire 30 days after the date at the top of page one of this agreement if not accepted in writing by "Owners" and returned to "Nexus" along with the necessary deposits within that time frame. Changes in the Work: During the course of the project, "Owners" may order changes in the work (both additions and deletions). "Nexus" will determine the cost of these changes and the cost of this additional work will be added to "Nexus" profit and overhead. SPECIALIZING IN QUALITY FINISH CARPENTRY, REMODELING, SPECIALIST ROOF SYSTEMS, SITE AND PROJECT MANAGEMENT A Page 4 of 4 People Authorized to Sign Change Orders: The following people are authorized to sign Change Orders: "Nexus": Mark Gotobed or Ged White -eli�nt,': Robert 6 ,�Krnbcrley Denney Concealed Conditions: This Agreement is based solely on the observations "Nexus" was able to make with the area in its current condition at the time this Agreement was bid. If additional Concealed Conditions are discovered once work has conunenced which were not visible at the time this proposal was bid, "Nexus" will stop work and point out these unforeseen Concealed Conditions to "Owners" so that "Owners" and "Nexus" can execute a Change Order for any Additional Work. Schedule of work It is agreed by both parties that this work will be coordinated with the "Owners" and "Nexus" to be undertaken in various stages to avoid complete disruption of the home environment. "Nexus" will give "Owners" no less than 2 days notice prior to arriving on site for commencement of any of the agreed stages of work to allow "Owners" to prepare. "Owners" commits to have sites identified for construction work available for start at the beginning of the scheduled day so as to avoid any unnecessary delays. Contract Cost and Payment Schedule: Total cost of work description and materials included in the proposal (except materials/work stated) - $14, 575.00 (Fourteen thousand flve hundred and seventy five dollars and zero cents) PAYMENT SCHEDULE 1st Payment due upon receipt of permit 2nd Payment due ul)on Installation of sheetrock TOTAL $4,859.00 Final payment due upon completion of scope of work TOTAL $4,858.00 TOTAL $4, 858.00 Amount due upon signing this contract - .$ — contract #1 deposit covers this reques I have read and understand, and I agree to, all the terms and conditions contained in the propos Date .... ........... "Nexus" Authorization ...... .......................... Date ...... .......... .. Client" Authorization.PT,,.�<-�... .. K/ Date ........ 3. ........ .. Client" Authorizatic SPECIALIZING IN QUALITY FINISH CAF SYSTEMS, SITE AND , REMODELING, SPECIALIST ROOF T MANAGEMENT The Commonwealth ofMassa.�husefis Department of IndustrialAccidents I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass-gov1d1a Wetkers, compensation Insurance Affidavit: Bailders/ContractorsXWetri TO BE, FMBID VITH TBE PF-PMTT)NC'c AUTRO"JTY' Please Print Leg!�l A �ppllcantynforMafiffll Name, (B-,isiucss/organization/Individual): Address: P 0 &27N gi�� City/State/Zip: Areyou an employer? 6e�kt& app"riopriate box: -7r Phoile#:7?1 '� 00 U06) I.F1 I am * a employerwith --L--��Ioyoos (flu and/or part-time).* for me in I am a sole proprietor or partnership and have no eMPloyecs'WoTk'rfg any capacity. (No workers, comp. insurance required.] I am a homeowner doing all work myself, [No workers, comp. insurance required.] t 4.[] lam a homeowner and will be hiring contractors to conduct all work on my proPertY. lVVill ensure that all contractors either have workers' compensation insurance or are sole 5. R1 i am a general contractor and I have hired the sub-cofitractois listed on the attached sheet. ---Thes . o sub-contractors`�aV'e ei�ploye�s and have w�rkers' coi�p- insurancG.� M (2ke-- 6.FJ We are a corporation and i ts offiqqrs have exercised their right of 'exemption p or MGL c. 152, § 1 (4), M4 v�a hav ��S. [No workers, comp. insurance required.] Type of project (TqqUired): 1. New construction 8. kllRemodelfrig 9. Demolition 10 FJ Building addition 11. F1 Electrical repairs or additions 13. 0 Rooft ' epairs 14.E] Othbr I n policy infbrm�fi— *Any applicant that checks must s4binit a now afff davit indicating such. f Homeowners who sfib and state -whether or not those entities have TContactors that check thi employees. If the sub -c6'. I am an employff th ees.' Below is thepollcy andjOb Site information. Insurance Company Policy 9 or Self -ills, Lio- Expiration Date; fob Site Address: City/State/Zip: Attach, a copy of the Workers, compelisation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required -under MGL o. 152, §25A is a criminal violation punishable by a fine up to $1,500-00 and/or One-year imprisonment, as well as civil penalties in the form of a STO-P WORK ORDER and a fine of up to $250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigati6lis of the DIA for insurance coverage verification. �dohe�reh fpejjvry that the informationprovided above L'q true and correct. y cer�fify unde he ains andpenaltles o Phone offleial use only. Do not -write in this area, to he completed by city or town Official City or Town: Permit/License issuing Authority (circle One): i 1.13oardoff(ealth 2. )Building Department 3. CitylTown Clerk 4. Electrical inspector 5. Plumbing Ynspector 6. Other Fhone#: Contact Person' Massachusetts General Laws chapter 152 requires aA employers toprovide workers' compensation for their employees. in e sery e Pursuant to this statute, an employee is defined as "...every person th ic of another under any contract 6f Aire, express or implied, oral or written." All employer is defined as "an ind&iduo, partnersWp, associati�n, carpoTation or other legal entity, or'any two or more of the foregoing engaged in ajoint 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 ofthe 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 b6 deemed to be an employer." MOL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the ls�suance or renewal of a license or permit to operate a businesg or to construct buildings in the.commonwea" 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 !h6boxes that apply to your situation and, if necessary, supply sub'contractoi(s) naine(s), address(es) and -phone number(s) along with their cartificate(s) of —insurance�L-imite&Liabilit3r-C-ompan-ics-(�-C-)-or-Limited-L-iab-ility?utnffrshiVs(E;LPY-w-itlrn—o-bem--p-iro-yeeso er anth members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP do . es have employees, a policy is required. Be advised that this affidavit may,be submitted to the Depaitment of ffidustrial Accidents fb� confirmationofinsurance, coverage. Also be sure to sign and date the a.Mdavit. The laffidavit'should be returned to the city or town that the application for the permit or license is being requested, noi the Department of Industrial Acciden�s. �hould you have any questions regarding the law o*r if yoa'are r�qt �*Iredfto obtain aworkers' compensatioti �olic�, please call the Department. at the number listed below. Self-fiisur6d companies should'enter-their - self-insuranZe 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 Investig4tions has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple pertnit/license, applications in any giv* on year, need only submit one affidavit indicating current poli' information (if necessary) and under "Job Site Address" the applicant shouldwrite "all locations in (city or cy 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. Anew 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 Department's address, telephone and fax number: The Commonwealth of Massachuset ts Department of IudustrialAccidents I Congress Street, Suite 100 Boston.7 MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAPE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia 1 0 ACCOR" CERTIFICATE OF LIABILITY INSURANCE k.� DATE (MM/DDAI`YYY) 1 3/8/2016 THIS CERTIFICATE 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 THEASSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If 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, certiln policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(Is). PRODUCER Cross Insurance -Peabody 139 Lynnfield Street Peabody MA 01960 CONTACT Lauren Goldman NAME: (978)532-5445 (FAX I A/C. No): (978)532-2217 E-MAIL ADDRESS: Igoldman@cros IS agency. com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A.Western World Ins. Co. INSURED Nexus II Services LLC P.O. Box 2821 .Woburn MA 01888 INSURER B:Saf ety Indemnity 33618 INSURER C: INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER-.CL15102253381 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPEOFINSURANCE ADDLSUBR INSD WVD POLICY NUMBER POLICY EFF (MWDDNYYY) POLICY EXP (MWDDNYYY) LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F1 OCCUR NPP8290737 8/12/2015 8/12/2016 EACH OCCURRENCE $ 1,000,000 DA AGE To RENTED PREM MISES (E. occurrence) $ MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRO- LOC POLICY 7 JECT F OTHER, GENERAL AGGRE ATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 Damage to Rented $ 50,000 B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS 3116632 11/10/2015 11/10/2016 COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY (Per person) $ 500,000 BODILY INJURY (Per accident) $ 500,000 PR ER DAMAGE (P Op . Z I $ 100,000 era d Medical payments $ 5,000 UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRlETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA PERT ST JOTH A UTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEd $ E.L. DISEASE - POLICY LIMIT I S DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be aftached if more space is required) Kim and Rob Denney 35 Sandra Lane North Andover, MA 01845 ACORD 25 (2014/01) IN%n2s (2niAnii SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Goldman/MD1 AM24 6- @ 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD G6ra;d While `23,GleMaIeDr. "W 01923, ttrttary Not -valid without signature 44 00Y M -assachuseft -,J)HDP2rtm e tit Public Ss 4bt guilding Reguiations and Standards S00% CS.,073991 I Al .-�GERALDVVWT 'ZD 23 GLEN DAL s Expir i6 oiler of Rusinen Riguls,601j". Litense or re asumtt Affidis, & -, - 1 1,: bef6re t�e ex Om NTRACTOR E-IMMOVEMEW CO e istrstiom 129177 �Ypqz A Office of Cor T Ib ?ark (piraff n: And'Widual A id VVhft6 G6ra;d While `23,GleMaIeDr. "W 01923, ttrttary Not -valid without signature 44 -M,