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HomeMy WebLinkAboutBuilding Permit #736 - 38 MONTEIRO WAY 6/12/2008Permit NO: Date Issued: &//4 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received IMPORTANT: Applicant must complete all items on this -Daae LOCATION3?'i"'!pJ✓T.d © 41/9 p ti�eo 0 , �, �-w 0 Print PROPERTY OWNER f ae- 4' A/rrO7/1,a4 r9,6Uvzf`D« 5— Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no _ Machine Shop Village ves no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alter No. of units: Commercial ent Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: �iSra<ivU` 2�/°G/l�,L I/TCf1�iv G/J,6Jr• Identification Please Type or Print Clearly) OWNER: Name: iturJr�Zr,�, ,� ��„z j -,c Phone: 97e- Address: 3 a ^7pj✓ x'11 s 2 4./I y' CONTRACTOR Name:��ria��i- ovs��N coyr� J� Phone: Address: /c? c�z�y„ev' si 2 Supervisor's Construction License: CS 7 -2 93 Exp. Date: 3,rJ �`,� Home Improvement License: / 3t ,2 o Exp. Date: e 2 o S ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ 0 Oc <14p, FEE: $ 7`O Check No.: S -9,7S.", Receipt No.: 212-33 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS ti A ' HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Signature Reviewed on Signature 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 Osaood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 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 M. Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (if Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ' ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses f ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals ;" that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location No. 7 ?4 Date Azz MORTh TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 4QG Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 i 3 3 Building Inspector From: 781-3934959 To: 19786889542 Page: 3/3 Date: 6/12/20089:34:31 AM A.CORD„ CERTIFICATE OF LIABILITY INSURANCE 6iiziz oe ) PRODUCER (781)393-4321 FAX: (781)393-4959 LoPriore Insurance enc Y 394 Main Street Medford MA 02155 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC it INSURED Mitchell Design 6 Construction Inc 10 Thorndike Street Everett MA 02149 INSURERA:XS Brokers Insurance INSURER B: Travelers Indemnity 25682 NSURER c: AIG Insurance INSURER D: INSURERE: 'OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN 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. IMAY HAVE BEE 4 REDUCED BY PAID rLAIMS- INSRD DD'L OF INSURANCE POLICY NUMBER Y EFFECTIVE DATE MMIDO/M POLICY EXPIRATIONTYPE DATE LIMITS rA LIABILITY COMMERCIAL GENERAL LIABILITY 7 CLAIMS MADE E1OCCUR 3CW6815 2/16/2008 2/16/2009 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED SO 000 PREMISES Ea occurrence)S MED EXP (Any oneperson)_exclude PERSONAL 8 AOV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 GEN'L AGGREGATE LIMIT APPLES PER. X POLICYFI PELT F LOC PRODUCTS - COMP/OP AGO. 2,0 0,000 B AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS X SCHEDULED AUTOS X HIRED AUTOS X NON OWNED AUTOS BA -22000803 12/2/2007 12/2/2008 COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) $ 100,000 BODILY INJURY 3300,000 (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE WIBILITY ANY AUTO AUTO ONLY - EA ACCIDENT 3 OTHER THAN AUTO ONLY: GG EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION EACH OCCURRENCE AGGREGATE $ C WORKERS COMPENSATKNJ AND EMPLOYERS' LIABILITY ANY PROPRIETORJPARTNEREXECUTIVE OFFICERIMEMBEREXCLUDED? 11 yes, describe under SPECIAL PROVISIONS below WC684-63-45 6/29/2008 6/29/2009 ST ^T S OTH- ER E.L. EACH ACCIDENT _ E.L. DISEASE - EA EMPLOY E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS/LOCATKHJSIVEHK:LESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION (978) 688-9542 SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE Town of North Andover EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAL 1600 Osgood Street N Andover, MA 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Rich Moretti/RICH �•di�� ACUKU 25 (20UT/Da) © ACORD CORPORATION 1988 1 NICMt m, ro� nn, Pere 1 ri 7 This fax was sent with GFI FAXmaker fax server. For more information, visit: hfp:/twww.gfi.com u CONTRACTOR AGREEMENT THIS AGREEMENT made the 30, day of May, 2008 by and between Mitchell Design & Construction Inc, 10 Thorndike St Suite #2 Everett Ma, 02149 Ma Reg. #136209 and C.S. # 072839 hereinafter called the Contractor and Heather Abourjaily, hereinafter called the Owner. Witnesseth, that the Contractor and the Owner for the considerations named agree as follows: Article 1. Scope of the Work The Contractor shall furnish all of the materials and perform all of the work as described in the Specifications below and attached hereto as it pertains to work to be performed on property at 38 Monteiro Way, N. Andover Ma. Article 2. Time of Completion The work to be performed under this Contract shall be commenced within two weeks of receipt of the building permit and shall be substantially completed in 4-6 weeks. Time is of the essence. Article 3. The Contract Price The Owner shall pay the Contractor for the material and labor to be performed under the Contract the sum, of THIRTY NINE THOUSAND ONE HUNDRED THIRTY SIX dollars ($39,136.00), subject to additions and deductions pursuant to authorized change orders. Article 4. Progress Payments Payments of the Contract Price shall be paid in the manner following: Payment # 1- At contract signing- $5000.00 Payment # 2- Receipt of permit- $ Payment # 3- After Demo -$5000.00 Payment # 4- Substantial completion of rough frame -$7000.00 Payment # 5- Substantial completion of siding-$ Payment # 6- At rough electrical & plumbing inspection -$5000.00 Payment # 7- Substantial completion of wall board -$5000.00 Payment # 8- Substantial completion of kitchen cabinets- $5000.00 Payment # 9- Substantial completion of trim work -$2500.00 Payment #10 -Substantial Installation of flooring - $3500.00 Payment #11- Final completion- $1136.00 Article 5. General Provisions 1. All work shall be completed in a workman -like manner and in compliance with all building codes and other applicable laws. 2. To the extent required by law all work shall be performed by individuals duly licensed and authorized by law to perform said work. 3. Contractor may at its discretion engage subcontractors to perform work hereunder, provided Contractor shall fully pay said subcontractor and in all instances remain responsible for the proper completion of this Contract. All contractors & subcontractors must be registered by the administrator and any inquires relating to a registration should be directed to the administrator. 4. Contractor shall furnish Owner appropriate releases or waivers of lien for all work performed or materials provided at the time of final payment. 5. All change orders shall be in writing and signed both by Owner and Contractor, Mitchell Design & Const. Inc shall not be liable for any implied or oral statements made by any subcontractor or representative that is not in the written project scope or signed change order. M# & 6. Contractor agrees to remove all debris and leave the premises in broom clean condition. All excess materials not incorporated into the job remain the sole property of MITCHELL DESIGN & CONSTRUCTION INC. 7. In the event Owner shall fail to pay any periodic or installment payment due hereunder, Contractor may cease work without breach pending payment or resolution of any dispute. In the event that a payment is not made on the due date, interest shall accrue at a rate of 1 '/2 percent per month along with collection costs and attorney fees. 8. : All disputes hereunder shall be resolved in the Commonwealth of Mass. In the court of Middlesex County. 9. Contractor shall not be liable for any delay due to circumstances beyond its control including strikes, casualty or general unavailability of materials. If any delay is realized as described it is understood that the contract completion date will be extended equally. 10. Contractor warrants all work for a period of 12 months following substantial completion. Warranty is null and void if last payment is not made IN FULL. 11. The contractor shall exercise care in performing all work, but shall not be responsible for stress cracking of plaster, loosening, or nail/screw popping of existing walls & ceilings. Should any repairs be made the contractor will not be responsible for repainting or refinishing. The contractor is not responsible for accidental damage caused to landscaping, sidewalks, and/or asphalt paving caused by implementation of said work. 12. The contractor shall match existing conditions as best as possible where applicable. (Sometimes it is impossible to match color and/or texture such as stucco, plaster, siding, roof shingles, etc.) 13. The owner shall provide sanitary facilities for the workers during construction. 14. The owner shall provide electrical power for lighting and equipment to perform said work. 15. Should a permit or financing for this project be unobtainable, the deposit shall be refunded less reasonable contractor costs. 16. The contractor may place a sign on the property during, construction advertising his name, telephone and abilities. 17. The owner has the right to cancel this agreement provided the contractor is notified in writing by mail posted, or by delivery not later than the 3`d business day following the signing of this agreement. 18. Contractor shall obtain all necessary permits for the work to be performed. The fee for said permits shall be in addition to the contract price in article #3 19. NOTICE TO OWNER: Any homeowner or owner who secures their own permits will be excluded. from the guaranty fund provisions of G.L. c. 142A. Article 6. The general provisions of this contract and articles 1 — 6 have been read and are mutually agreed to and accepted by both parties to which have set their hand to this contract Signed this, 30 day Do Not Sign This Contract if There Are Any Blank Spaces By: By: MITCHELL DESIGN & CONTRUCTION INC. O OWNER •t 6. Contractor agrees to remove all debris and leave the premises in broom clean condition. All excess materials not incorporated into the job remain the sole property of MITCHELL DESIGN & CONSTRUCTION INC. 7. In the event Owner shall fail to pay any periodic or installment payment due hereunder, Contractor may cease work without breach pending payment or resolution of any dispute. In the event that a payment is not made on the due date, interest shall accrue at a rate of 1 '/2 percent per month along with collection costs and attorney fees. 8. : All disputes hereunder shall be resolved in the Commonwealth of Mass. In the court of Middlesex County. 9. Contractor shall not be liable for any delay due to circumstances beyond its control including strikes, casualty or general unavailability of materials. If any delay is realized as described it is understood that the contract completion date will be extended equally. 10. Contractor warrants all work for a period of 12 months following substantial completion. Warranty is null and void if last payment is not made IN FULL. 11. The contractor shall exercise care in performing all work, but shall not be responsible for stress cracking of plaster, loosening, or nail/screw popping of existing walls & ceilings. Should any repairs be made the contractor will not be responsible for repainting or refinishing. The contractor is not responsible for accidental damage caused to landscaping, sidewalks, and/or asphalt paving caused by implementation of said work. 12. The contractor shall match existing conditions as best as possible where applicable. (Sometimes it is impossible to match color and/or texture such as stucco, plaster, siding, roof shingles, etc.) 13. The owner shall provide sanitary facilities for the workers during construction. 14. The owner shall provide electrical power for lighting and equipment to perform said work. 15. Should a permit or financing for this project be unobtainable, the deposit shall be refunded less reasonable contractor costs. 16. The contractor may place a sign on the property during, construction advertising his name, telephone and abilities. 17. The owner has the right to cancel this agreement provided the contractor is notified in writing by mail posted, or by delivery not later than the 3`d business day following the signing of this agreement. 18. Contractor shall obtain all necessary permits for the work to be performed. The fee for said permits shall be in addition to the contract price in article #3 19. NOTICE TO OWNER: Any homeowner or owner who secures their own permits will be excluded. from the guaranty fund provisions of G.L. c. 142A. Article 6. The general provisions of this contract and articles 1 — 6 have been read and are mutually agreed to and accepted by both parties to which have set their hand to this contract Signed this, 30 day Do Not Sign This Contract if There Are Any Blank Spaces By: By: MITCHELL DESIGN & CONTRUCTION INC. O OWNER f R �W- J co -,u'5 CL � + Lj— CD Cdr L-- I 2 a- �[ f c cn C F1 Ms q 'm W h t2 �¢ x9) W4 Aa d0 -u w° E U) ou W z A ,. or. a w° °° a°' U m w O w � aw rm C2 w O w U!) 0 a w oo - u U C's°D x o U aw., d c7 94 co w W A w w c = z cn Q o cn O F=04 0 z E if M _ N O N C 0 v m O 92 m c m 0 m C �C N O O 2 O 5 cm F. �O u z r� u Cf) 1�1 2 M t Co 0 E L Q o Q Z CD C. O y C C as cm Icca� h C C OO m CD H = CL ♦.a C � i Cl Q CL cMQ c y � � C ca R V C CD CL V vs � C — c CO) LLI 0 II�w M/ LLI U) W W V9 LLIW 0 c o m c o Q c ` O H ; W O :vV •C' CL. C A to OC o M O CA CD CL N E C D C., S CCD -CMD co CA m m �.Cc a 'a =C O: N cc � SO E� o:tQ N O _ VJ ,C= OCD O c � o n N O C = m 0� 3 ~ r0.. ;a o � y O •O.. ~ VD HN S ea = CD -S 70 LL •N O �••• C �d= A H C W •� �.. vy v cm V O is CD N_ a USmaHo O � 0:5 Z cc = w dr m E if M _ N O N C 0 v m O 92 m c m 0 m C �C N O O 2 O 5 cm F. �O u z r� u Cf) 1�1 2 M t Co 0 E L Q o Q Z CD C. O y C C as cm Icca� h C C OO m CD H = CL ♦.a C � i Cl Q CL cMQ c y � � C ca R V C CD CL V vs � C — c CO) LLI 0 II�w M/ LLI U) W W V9 LLIW 0 BUILDING PERMIT °f NORTH q StLeD 16 TOWN OF NORTH ANDOVER�tb`'' APPLICATION FOR PLAN EXAMINATION Permit NO: �� Date Received � ��SSACHU`-+���y Date Issued: A� MPORTANT: Applicant must complete all items on this paize LOCATION 31? m o4't&-O� &C'#y /V A', -,'a6 v� PROPERTY OWNER L' 4 A{-- Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village ves no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One fami Addition Two or more family Industrial Iteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Se ' Well Floodplain Wetlands Watershed District _qqtiter/Sewer DESCRIPTION OF WORK TO BE PREFORMED: �y� ,S� .Gx�.r-t-r..� .cx�Co2i�ar2 t,vat [ f i2�2a�K -ice Ac��v+�Gd�c /-� lS�•,e-� 11/0a69 VA:f!19 bec.'-is- `� Identific,,��tion P ease Type or Print Clearly) �j 7 OWNER: Name: tt A41Pr ¢ N� 1A 1 J I IVl/'I i 1\1 Phnna•�_Z5-a- 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: $ 4"I" j"s"g'- e4'FEE: $ 'Po— Check No.: /a.Ta/ Receipt No.: Q//6 0 NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 5ignature of Agent/Owner Signature of contractor 5 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans DISPOSAL Tanning/MassageBody ArtSwimming Pools WEWERAGE Tobacco Sales Food Packaging/Sales nk, 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 012 - COMMENTS No uk"k-Q"KoyuJS L11,A �A t lA 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 DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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 J,(, 0 Notified for pickup - Date Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ 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 O Deck uilding Permit Application ❑ Certified Surveyed Plot Plan Workers Comp Affidavit u 'Photo Copy of H.I.C. And C.S.L. Licenses a'Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location -- No. G 7-7 `Date S 16 6�P' MaRTM TOWN OF NORTH ANDOVER Check #10.P QW0 Certificate of Occupancy $ Building/Frame Permit Fee $ 210 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Buifd g Inspector Q 114 kl\7 1) -. v - 191, I 4Z_ P, CO C, 0 C'V 0 E 4Z_ v `k C,4 v �► 'Rt IN 1 - � Na �5 PROPOSAL �� f✓�/sv, C�f4W ��� tS ��x�ti --mss--y �, PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: NAME ADDRESS /'�/ - 1-i �is�u�•�'2 f �i� PHONE N0. ADDRESS DATE OF PLANS ARCHITECT SHEET NO. DATE We hereby propose to furnish the materials and perform the labor necessary for the completion of .r ' r � 4;t'49 Z44 r All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifi- cations submitted for above work and co leted in a substantial workmanlike manner for the sum of Dollars ($ s c acs ) with a ents to be made as follows. �3 t / Respectfully submitted Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge Per over and above the estimate. All agreements contingent upon strikes, ac- cidents, or delays beyond our control. Note—This proposal may be withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work r as specified. Payments will be made as outlined above. Signature � i Date �/ bG Signature &..- NC 3818-50 PROPOSAL •�w� -47 57 .r .. z 74 surronr (ISIS isy, = - reyb0 a Fb - st a rt HILL cs - 89 - 9G. 77 1103 7 L+ rot 25 rIz ac S. 41 Q to-.! tclJ& ZS �� tC7- sa aS ue L92bo as tao ze Hso $A cs %00 „4, ` O :t2 tt3 tt4 f15 t0. it / � zs ax aseee zs am \ `Qt ON toe _ �._i -•ae,� 39 5-r REST c - e 2%, 10 C O tw ut n_ to r 140- t.� O� Z t i tat s+ttz Alf't Y5 Q na, row -r. u,Tu �ro ,f. 39 u2-, 2 tL to i �inJ � t J.7 ' az yf. S Ila �♦ 1.9" Lli 1 15.01A S.F. `•'•' t36 Mot-relTzo xa,� t 43 V) C t %,5,037 3.' xS.�S> >s. 1 1S u. flog i36 td4 13'7 t 28• Z� S F 2.377x L ss. t� t26 t27 `=a 147 taro 60 .E PLAT N .47 q) 3 _ l7 o ii_ a� 1 29, G72 S F. a� .-.,. 74 MORTGAGE INSPECTION PLAN BOSTON - SURVEY, INC. 99-03962 P.O. Box 220 Charlestown, MA 02129 (617)242-1313 MAIN (617)242-1616 FAX APPLICANT.- JONES LOCATION. 38 MONTEIRO WAY DEED/CERT: 3204-252 CITY, STATE. NORTH ANDOVER, MA PLAN REF: BOSTON SURVEY, INC. 99-03962. P.O. Box 220 Charlestown, MA 02129 (617) 242-1313 MAIN (617) 242-1616 FAX APPLICANT. JONES LOCATION: 38 MONTEIRO WAY DEED/CERT 3204-252 CITY, STATE- NORTH ANDOVER, MA. PLAN REF: m 2 GROU Information [1] Named Insured and Mailing Address WILMINGTON WINDOW & DOOR INC. 432 Main Street Wilmington, MA 01887 Federal Employer's ID 04-3449705 Risk ID Number 000252178 Renewal of NEW NCCI No.[25844] Agency PAYCHEX AGENCY, INC. 150 Sawgrass Drive Rochester, NY 14620 Agency Code: NYPAYC10 Insured is Sub -Chapter Corp [2] Policy Period From August 14, 2007 to August 14, 2008, 12:01 AM, standard time at the insured's mailing address. [3] Coverage A. Workers' Compensation Insurance -Part One of this policy applies to the Workers' Compensation Law of the following states: Massachusetts B. Employer's Liability Insurance -Part Two of this policy applies to work in each of the states listed in item [3]A. The limits of our liability under PartTwo are: Bodily Injury by Accident - each accident $100,000 Bodily Injury by Disease - each employee $100,000 Bodily Injury by Disease - policy limit $500,000 C. Other States Insurance - Part Three of this policy applies to all states, except any state listed in item [3]A. and the states of North Dakota, Ohio, Washington, West Virginia, and Wyoming. D. This policy includes these endorsements and schedules: See Extension of Information Page - Schedule of Forms [4] Premium The Premium Basis and, therefore, the premium will be determined by our Manual of Rules, Classifications, Rates, and Rating Plans. All required information is subject to verification and change by audit. (Continued on another page) Total Estimated Policy Premium $ 4,259 Total Surcharges/Assessments $ 218 Total Estimated Cost $ 4,477 INTERNAL USE N2 Page - 1 - Information Page MGA : WIWC804306 WC Information A Date :08/16/2007 MANOTE 16 South River Street • P.O. 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