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HomeMy WebLinkAboutBuilding Permit #0754-2017 - 440 GREAT POND ROAD 2/6/2017 • BUILDING PERMIT of , TOWN OF NORTH ANDOVER. APPLICATION FOR PLAN EXAMINATION Date Received � � �o� n Permit No#: o� � �� �q•17HD i, SSAcims Date Issued: 7 - EVRORTANT: Applicant must complete all items on this page Tin.t PROPER y, - Pnnt Tap�YearStructure Yes p�Ap, PARCEL .2 6i D1STRIC�TH�s#ortc ®istnt' yes j - t Machine. ho P1,V[Ilage, _yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building Imine family ❑Addition ❑Two or more family ❑ Industrial alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑Demolition ❑ Other [j Septic We (].Ffpod' Iain Vlletl'ands laterslied i'sf�ic� a_t_er/Sewer*, �. DESCRIPTION OF WORK T I3E PERFORMED: Identifica " n Please Type or Print Clearly OWNER: Name: o<�56 ,o Phone: a'7f 76/ Address: C• =a'ctor Phoiie: Y onff am - Address:, A-V u eniis©r'sCoisfrUctlori Licenses __ :.C,.. __,.�Ex Date. ..p _ - --- - a'F �� - - y Hare;Improvement:License: ��.__ __ - -- - - _ _ 'Exp Dates 6 Y or ARCHITECT/ENGINEER o'er' G,� �r�� Phone: :? 7° 3G Address: �/� S W,�loeor, Reg. No. FEE SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125,00 PER SA �.-_ irotal Projeo Cost: $y�- ,1�� 00.00 FEE: $ Check No.: 2—`f Receipt Ncf,. " TJE: leer y �on c with unregistered cont actors do teat iia ej�Ices t t�e gr.,aranty fund Plans Submitted Plans Waived ❑ Certified Piot Plan ❑ Stamped Plans ❑ ' f- TypE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanninga4assage/Body AAxt ❑ SW mming Pools ❑ we'll ❑ Tobacco Sales ❑ FoodPackaging/Sales ❑ Pxi'.vate(septic tank, etc. ❑ Pennmezit Dumpster on Site ❑ THE FOLLOWING SECTIONS ,FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF a U FORM PLANNING & DEVELOPMENT Reviewed On Signature .COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeais: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water &Sewer Con neCti0ll/51g11ature &Date Driveway Permlt DPW Town Engiueer: Signature: Located 3B4 Osgood Street I FIRE DEPARTMENT- -.Temp Dumpster on site yes no Loeated at 124 Main Street Fire Department signatureldate tIORTH own =' �* ndover . ® kL .2b,7 et+ -4_ b Mass, �- LAK6 Vei'� Q CCCu.iC KeWKK 4 A0 4rE v U BOARD OF HEALTH Food/Kitchen EKmmmlT T LD Septic System THIS CERTIFIES THAT .... .f. .... ......................................... BUILDING INSPECTOR has permission to erect ............................ buildings on Foundation Rough to be occupied as .. ��." ly ..!/�/.R� � 1 Chimney provided that the person accepting this permit shal In every respect conform to the terms of the applications inal on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Y$ 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 ELECTRICAL INSPECTOR UNLESS CONST CTIA Rough LeAlIkliz- Service Final BUILDING IN CTO GAS INSPECTOR ®ccupaucg Permit REquired to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Tall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. 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I � I ` ��. r�Fll I i � �k l �1fi 11 1:• 1.1 1• 1• /• ...�. 14 7 •.` A u IN tiW�V d� s II 1•� 1• 1•• 1• 1•' A�l fr Ply ;y�.: +k a �s nv iasra :: rr *h ., : n Js ,�, � � r I I �� 1 , ,r�: � a 7 y. �-•, 11 .I "I �� � •x.y e �.,�'�. ��+?:. �,r — ��'"dllt� .. 1���� y�l* J'�/yyl,� � !I•pl�'+. 1•• 11 / 1 1 q r '.". {riI MJII IpII ., t •M rI a. • { , r � � '' � I � � r�I 1"�r Ia�VJ�1� al t�i r P �VIs4 w ly q .. � 'l,y h4VI ya i1" a«t Y1� F t q fY F , Ad -° .:. " f f f. a hil1 ,'w.h94.{. Ilu ,�J_ oar:: t c i.:}, •, d�;' I,rS 1• 1 . .� �K ,E ��:-, ,� a I fp:4, h". � �; y" i 11J 'r vl � I�r�i,�;�rl,r,Y' y •9:a+,hhr.{ 1 at�l`x .y. ;y;s?�„ai w:sa °,,snlr r,, Ir," e.• ��S �' ,h uyb„ �'+�,��`:, � �.ulw r �v � Y rr�,..� a��, I�j�ll � 1�J � �� � 9l V u rt "�'� I r �.• dI �"V0! I e' F I, !y y u' "'vy dWV r 't• ,,4 ''n, 9r .+2 • 1 I! �n J" a a Iqt it A f x '2,d! x � r k i 4 f�� Ft a +�Yr"`11i11 r? t i t✓, ' ♦ ru I r.+ s{, i f �'�— 1 � r,��l r 'S �. �✓.:�L� +W •�[ 9`Fi ,� IlM�. t lyllk�'�', f rr h4a 4 4 k , rwar .tsvr �{ ,� � Le„y,�"- • • ".iV u:�u ,,; t � � i �� ;(. syn i� - I •1 rV 'rs. - ' - ,,vii. • F a� t �f d r � * T. ik i i Cost Plus Contract 1, Ke�.tionslfip _between the Parties; The Owner is supplying the Contractor with plans, specifications and/or design documents for the project. 2, Cost P1u�s Contract: This is to be a cost plus contract. It is nota "fixed price" the project cost, but the actual project cost Is contract, The Contractor will estimate osts of labor .and materials supplied by the ultimately determined by the actual c Contractor. The actual costs of construction may be higher, equal to, or lower than the cost estimated by the Contractor. This is not a"fixed price" or guaranteed maximum price tinder guaranteed maximum amount. Rather, the Owner is responsible to pay for actual expenditures by the Contractor and for comparing expenditures to the amotults estimated by the Contractor. 3. Components of Costs: Owner will pay all invoices to subcontractors and suppliers directly,and will paythe general Contractor a fee of 24%of all total invoices. 4. Cost Auditing: The Owner is permitted to review the material purchase receipts and subcontractor invoices each time the Contractor submits a monthly progress billing. Because there is no fixed price or guaranteed maximum price, the Owner should carefully review payment applications and supporting documentation. In addition, lien release forms have been provided as Exhibits to the Document, j, Bonds, Insurance: The Contractor and Owner are to contact their insurance atwents before signing this contract to make sure all the insurance requirements are met. The Contractor is required to provide insurance to the Owner insure the Work while in progress. Additionally, the Owner is to check the status of each potential subcontractor's insurance. wner that G, Contractor's Wan'an : In the documents, thecan ents Contractor nd free of material 0 st I ural the Work will be in accordance with contract do defects. I 7. Revisions: If revisions are to be made to this contract, they should be done so In writing. REENTTAL CONSTRUC N CONT,R2ACT 1'Co5t Plus) Parties: DC Development & Construction, LLC 100 Hale St. Haverhill, MA 01830 Contractor Manor Realty Trust Lucy Munyi and Samuel Kimungu, Trustees 2 Woolsack Dr. Westford, MA 01886 Owner Property: 440 Great Pond Rd. North;Andover, MA 01845 Date: 12/7116 1. THE VVQRK 11 Contractor's Duties. Contractor shall manage, hire and order on behalf of Owner, the material, labor, equipment, tools, and supervision (the"Work") necessary to construct a sin;le- farnily residence (the` "Project") for Owner on the Property in compliance with the plans and specifications supplied by Owner(the "Plans"), The Plans are attached as Exhibit A.. This Contract and all of its Exhibits, and all Change Orders after execution,are the"Contract Documents." Contractor agrees to immediately inform Owner in writing of any discrepancies, errors, or omissions in the Plans or materially changed or unanticipated conditions and not to proceed N ith any work affected by such discrepancy until Owner directs Contractor to do so. 12 Permits. Contractor shall obtain the governmental approvals of the Plans and all permits for construction of'ithe Project. Owner is responsible for cost of the building permit and other necessary permits. 11. �'RICE_AND PAYMENT 2.1 Estimated Project Cost. Contractor estimates the total cost of the Work to be Two Million. One Hundred Fifty-two Thousand, Fifty Dollars ($2,152,200.00) as set forth in Exhibit R (tile `Estimated Project Cost"), The Estimated Project Cost is organized by trade categories and systems. Exhibit B is an estimate only and it is based upon the Plans provided by Omer. The actual total cost of the Work may be higher or lower than the Estimated Project Cost. 2,2 The Cost of. ,the Work (Cost Plus Feel). Owner shall pay Contractor for the perl:or.mance of the Work a sum equal to twenty pereent (20%) of the Actual Costs of the total invoices paid to subcontractors and suppliers (the "Contractor's Fee"), plus sales tax. Owner shall pay all suppliers and subcontractors directly, including any deposit required by any subcontractor or supplier prior to the commencement of the subcontractor's work or suppliers purchase. "Actual Costs" include the following: (a) On-site Project personnel costs, but limited to those persons necessary for the proper performance of the Work, at the following hourly rates: (list by job title and hourly rate) (b) The costs paid for the purchase, installation and/or use of all materials, structural accessories, machinery, equipment or other items for the performance of the Work; (c) The costs paid for all insurance and governmental fees and permits for the Project; (d) The costs paid to subcontractors for their performance of the Work; and 2.3 Down Pa t_V llellt. Owner shall pay Contractor a down payment of One Ht1i_clred Thousand Dollars ($100.000.00) prior to commencement of the Work. The down payment shall be credited against the Cost of the Work beginning with Contractor's first Progress Payment. Owner has sufficient funds, either personal or through lender financing, in an amount equal to the Estimated Project Cost, 2.4 Pro resg_ s Payments. On the first business day of every month, Contractor shall present to Owner an Application for Payment based on the Actual Costs inured to that date plus the Contractor's Fee and plus sales tax, less previous payments. Owner shall pay the full amount billed, no later than Five'(5) calendar days from the date of receipt of each Application N. Payment. With each Application for Payment the Owner shall have the right to require Contractor to provide documentation to support those Actual Costs. Contractor shall apply Owner's payment only to the costs and fees of this Project. 2.5 Anticipated Actual Costs Exce n Estimated Project Costs. If Contractor reasonably believes that anticipated Actual Costs will exceed any Work component of the Estimated Project Cost in Exhibit B by more than ten percent (10%), then Contractor shall give prior written notice to Owner of the anticipated increase before completing that Work component. 2,6 Retainage, Owner shall not withhold retainage from progress payments. 2.7 Lien Release. Owner shall not be required to make any payment to Contractor unless and until Contractor provides Owner with an unconditional waiver and lien release form signed 1)), Contractor. Owner shall not be required to make any payments to subcontractors unless and until each subcontractor who is claiming Two Thousand Five Hundred Dollars ($2,500.00) provides Uwvner with an unconditional waiver and release form signed by subcontractor. Exhibit C-l.. 2.8 Final Payment. Within ten(10) days after Contractor notifies Owner that the Work is Substantially Complete, Owner shall inspect the Work with Contractor and deliver to Contractor a comprehensive list of items to be completed or corrected (the "Punch LisV), The Punch List and other Work shall be finished by Contractor within thirty (30) days of Contractor's receipt of the Punch List. Final Payment shall be due when the Contractor provides the Owner with final lien releases from Contractor and all subcontractors and suppliers, conditioned only on receipt of Final Payment attached as Exhibit C-2; "Substantially Complete" or "Substantial Completion"ineans the stage in the progress of the Work when Owner has legal occupancy and full and unrestricted lyse Project for its intended purpose with only minor incidental work or correction or incl benefit of the Pto P p J repair remaining to be performed by Contractor. 2,9 Failure of Payment. If Owner fails to pay Contractor amounts due within five (5) days of the time required by Section 2.4, Contractor may, upon providing seven (7) days written notice to Owner, suspend the Work until the amounts due have been received, If the failure of payment remains uncured.for five (5) days after the first written notice, Contractor may terininate the Contract. Payments due and unpaid under the Contract Documents shall bear interest at the rats: of twelve percent(12%) per,annum from the date payment was due until paid. 111. f_JJLNLGE 3,1 Nature of Chan e. If Owner or Contractor requests, or one of the parties believes that a change is necessary, (a"Change"),then the parties shall comply with the following procedure to reflect a Change in the Work: a, The Warty requesting or noting the Change shall write a description of the Change and give the other Party that writing (the "Change Notice"); b, Before proceeding with the changed work, unless excused by an emergency involving safety or property damage, the Contractor shall provide Owner with a fixed-price written estimate of the cost and time impact of the requested Change; C, Owner and Contractor shall execute a Change Order confirming their agreement with -the Change, the fixed-price cost, and the extension of the Substantial Completion date, if any. If the Change cannot be performed on a fixed-price basis, the Change Order shall identify the agreed method of compensation. d. Owner shall pay the Contractor the total cost of the change order prior to any work being commenced pursuant to the work order. 3? Charlie Orden Format. A blank Change Order forrn is included in this Contract as Exhibit E. IV, SCHEDULE 4.1 Commencement and Completion of the Work, Contractor shall commence the Work within ten (l 0) calendar days of receipt of a building permit and down payment. Suviect to the permitted extensions and;delays provided herein, Contractor shall Substantially Complete the Work within fifteen months (456) calendar days after the commencement date. With its first Application for Payment, Contractor shall provide a schedule indicating proposed subcontractors' activity sequences and durations, deadlines for Owner's decisions on material selections, and nAestones for delivery of materials. The schedule is included in this Contract as Exhibit F. 42 Construction :Time and Liquidated Damages. Contractor agrees that the time in Section 4.1 to reach Substantial Completion, as reflected by Contractor's schedule, provides sufficient time for the expeditious and practical execution of the Work. 4.3 Deli. If the Project is delayed by the act, neglect or default of Owner, Owner's agent. Owner's design professional, Owner's lender, governmental action or inaction, any contractor employed by Owner, any materials supplier acting for Owner, or any other reason or reasons beyond Contractor's reasonable control, including without limitation damage caused by fire or other casualty, strikes, force majeure, shortage of materials or labor, transportation delays. weather conditions, change :orders, or deficiencies in the Contract Documents (the "Excusable Delay"),then the Substantial Completion date shall be extended for a period reasonably equivalent to the tune lost by reason of Stich delay. 4.4 Notice of Delay, Within a reasonable time following the date Contractor knows. or within reasonable diligence should know of an Excusable Delay, but in no event longer than severs (7) days, Contractor shall notify Owner of the extension of time resulting from such delay. The extension of time shall be based upon Contractor's reasonable determination of the delay period. Any time extension to the Substantial Completion date shall be documented in a Change Order. V. INSURANCE Before commencing the Work and as a condition of payment, Contractor shall purchase and maintain insurance as described below from an insurer admitted to do business in Massachusetts, that will protect it from bodily injury or property damage claims arising out of its operations under this Contract, whether the operations are by Contractor, Contractor's Consultants or subcontractors, anyone directly or indirectly employed by any of them, or by anyone for whose acts any of them may be liable. 1. Commercial General Liability (CGL) insurance providing bodily injury liability and property damage liability with combined single limits of not less than $1,000,000 per occurrence,and $2,000,000 general aggregate limits, and Products/Completed Operations aggregate limits of $2,000,000, written oil an occurrence form. 2. Automobile liability 'insurance with a minimum limit of liability of not less than $300,000 per occurrence for all owned, non-owned and hired automobiles. if the Owner requires that Contractor's general liability policy be endorsed so that the aggregate limits of insurance apply on this job, both parties mast check the appropriate box: Owner [ ] Contractor [ I. 4. Owner shall be included as an additional insured under the CGL policy. Prior to starting work, Contractor shall provide a copy of the actual additional insured endorsement or blanket additional insured policy wording to the CGL policy that documents the Owner's additional insured status: Unless otherwise agreed, Owner shall secure and maintain property insurance upon the Work to its frill insurable value (replacement cost) including the peril of theft and, including materials delivered to the Property (whether those materials are actually incorporated into or adjacent to the Work), miscellaneous materials and supplies incidental to the Work and temporary structures. If work is to be performed on an existing residential structure, the Owner may retain an all risk homeowner's policy and delete any exclusion to theft of building materials. Owner's policy limit must be increased to contemplate the value of the existing structure and.improvements to be added. Owner and Contractor hereby waive their rights of subrogation against one another for any losses covered by the required insurance policies except that Contractor shall be liable for the properly insurance deductible if a claim is made against such property insurance and that claim arises out of Contractor's negligence. V1, CONTM!CTOR�RRALTY 0 Contractor's VarxantY. Contractor warrants that the Work shall be in accordance with the Contract Documents and free from material structural defects and shall return and repair any V,Jork not in accordance with the Contract Documents for a period of one (1) year from the date of Substantial Completion of the Work (the "Warranty Period"). All product warranties, if any, are deemed assigned from Contractor to Owner. C2 Cure of Defect. if a defect is discovered within the Warranty Period, then Owner must promptly notify Contractor in writing following the discovery of that defect (the "Warranty Defect Notice") and must provide Contractor with an opportunity to inspect and an opportunity to / either cure the defect in a manner customary in the industry or to pay to Owner the cost of repair or replacement of the defect as estimated by Contractor. This Warranty Defect Notice shall serve as the written notice of claim described in the following paragraph. In no event shall Contractor's liability exceed the fair and: reasonable cost of repair or replacement of the warranted defect. Contractor shall not be liable for any cost or expense incurred by Owner in remedying ally wan-anted defects unless Contractor has been notified in writing and has been afforded the opportunity to cure the claimed defect or to pay the sums specified herein,Nothing contained in this section shall be construed to establish a period of limitation with respect to Contractor's other obligations under the Contract'Documents G3 Limitation ofDaD mages. Contractor and Owner waive claims against each other for consequential damages. This inutual waiver includes,but is not limited to: (a) damages incurred by Owner for loss of income, profit, financing, business, and reputation; and (b) damages incurred by Contractor for losses of financing, business and reputation, and for loss of profit except anticipated profit arising directly from the Work, ']'his mutual waiver is applicable, without limitation, to all consequential damages due to either party's termination in accordance with Section 9. Nothing contained in this Section 6.4 shall be deemed to preclude an award of liquidated damages, when applicable, in accordance with Section 4.2. If any court determines that this section or its application to any person or circumstance is, to any extent, invalid or unenforceable, the remainder of this Contract shall not be affected thereby and each other term, covenant or condition of this Contract shall be valid and be enforced to the fullest extent permitted by law. VII. SAFETY Conti-actor and its subcontractors shall take all reasonably necessary safety precautions. including compliance with! applicable laws, ordinances, regulations, and orders issued by a or shall at all times be responsible for public authority, whether federal, state, or local. Contract p p providing a safe fob site :and 17c responsible for the work performance and safety of all employees. personnel, equipment, and materials within the care, custody, or control of Contractor or its subcontractors of any tier. Contractor and its subcontractors shall furnish all required safety equipment and ensure all of its employees and lower-tier subcontractors' employees have and wear personal protective equipment in compliance with applicable safety requirements. Contractor shall promptly provide Owner with written notice of safety hazard(s) or violations) found on the job site or of any injury to its or its subcontractors' workers incurred on the job site. VII1. INDEMNITY Contractor agrees to defend, indemnify, and hold harmless (the "Indemnity Duty'") Owner and its agents from and against claims, damages, losses and expenses, including but ;lot limited to attorneys' fees and costs and expenses, arising out of or resulting from performance of the Work, provided that such claim, damage, loss, or expense is attributable to bodily injury. sickness, disease or deg h, or to injury to or destruction of tangible property (other than the Worl< itself (the "Harm"), prc vided, however, that the Contractor owes no Indemnity Duty if the Harm was caused by or results from the sole negligence of the Owner or its agents or both, and provided further that in the event of concurrent negligence (i) by Contractor or the Contractor's subcontractors agents or employees, or both and (ii) by the Owner or its agents, or both, then the Contractor's Indemnity Duty is valid and enforceable only to the extent of the negligence of Contractor, its agents, a A its employees. JX, TERMINATION 9,1 T_ermina ion by Owner for Cause. Owner may, after giving Contractor seven (7) days ",ritten notice and an :opportunity to commence and continue to cure the alleged cause. terminate the Contract i Contractor violates any material provision of this Contractor, (a) refuses or fails to supply enough properly skilled workers or proper m ateri:als;or (b) persistently disregards laws, ordinances, rLdes, regulations or orders f public authorities having jurisdiction. 92 Terming ion by Contractor for Cause. In addition to Contractor's right to terminate the Contract pursuant W Section 2.9, the Contractor may terminate the Contract for cause if the ON.\,ner breaches any 3laterial provision of the Contract Documents. Prior to terminating the Contract for cause under this Section, Contractor shall first provide Owner seven (7) days written notice of the alleged breach.' If Owner fails to cure the breach within seven (7) days of receipt of such notice. or fails to commence and diligently continue with cure efforts if the breach cannot reasonably be cured wit lin seven(7)days,the Contractor may terminate the Contract. X, MBDIATIM The parties ag e to attempt to resolve any dispute through good faith negotiation as a condition precedent to omrnencing litigation, except where commencing litigation is necessary to 1)1•eserve lien or other s.milat rights, If negotiation is not successful,then before beginning any legal proceeding, other than o enforce this Section, the parties agree to engage in non-binding mediation conducted by a mediat r selected by them and in accordance with the Massachusetts State version of the Uniform Medi ition Act. Unless the parties agree otherwise, the mediation will be ill accordance with the -Tome Construction Mediation Procedures of the American Arbitration Association ("AAA"). Either patty may give written notice to the other party requesting mediation and the parties agree tc use their best efforts to conduct the mediation within sixty (60) days of the: notice. The parties will share the cost of mediation equally. The mediation notice and mediation process are not a condition to satisfying the notice requirements identified in Section 6 of this Contract or the recording ofa mechanics' lien. XL GENERAL 11.1 Survival In the event any clause or provision of this Contract shall be held to be invalid, then the remain ng clauses and provisions shall nevertheless be and remain in full force and effect. 11.2 Entire greeiiient. The Contract Documents contain the entire agreement between the parties with respec to construction of the Project. All other agreements, oral or written, are hereby merged into anc superseded by this Contract. There are no other agreements which modify or affect the terms her• of. No amendment hereto shall be binding; unless the terms thereof are in writing and signed by both parties. No verbal or other agreements modify or affect this Contract. 11.3 Binder Effect. This Contract shall be binding upon the parties hereto, and their heirs, successors, execu ors, administrators and assigns. 11.4 Assiann ent. Neither party shall assign nor transfer this Contract or any rights hereunder without the prior written consent of the other. 11.5 Notices. All notices which may be required under this Contract are to be in writing and delivered (a) to the attention of the party at the address listed on the signature page; or (b) by email to the email address on the signature page; or (c) by fax to the fax number on the signature page, or(d)mailed by certifW mail, postage prepaid,to the address listed on the signature page, All notices shall be deeme I served upon delivery, successful transmission, or two (2) days following deposit of the notice in the US, mail as required herein, 11.6 GoverniM Law,Venue. The performance and interpretation of this Contract shall be governed in accordanec with the laws of the State of Massachusetts. Any litigation arising out of or in connection with tl.is Contract shall be conducted in the County where work ispeifornied. CONTRACTOR, OWNER: y. _ Printed Name: Printed me: L_&Et L t �� Ti � c'.,t b Title:— r E-Mail• ! -Mail: Fax: Fax: ----- ticidress: Address: . Contractor License No. Exhibits: A -- Plats B --Esti-hated Project Cost dated _ C-1 — Unconditional Lien Release form C-2--C nditional Lien Release On Final Payment Foam D --Change Order EXHIBIT A, PLANS List of Plans provided by Owner: 4. EXHIBIT B ESTIMATED PROJECT COST (Yo be provided by Co tractor) i EXHIBIT C-l. CONDITIONAL WAIVER AND RELEASE UPON PROGRESS PAYMENT The undersigned has been paid and has received a progress payment in the sum of$. _... for labor, services,equi meat, or material furnished to _ on the job of (Maker of Check) _located at (Owner) (Job Description) and when the check has been properly endorsed and has been paid by the ban]( upon which it is drawn, the undersigned does hereby release any mechanic's lien, stop notice, or bond right that the undersigned has on the above referer cad job to the following extent,This release covers a progress payment for labor. services, equipment, or i iaterials furnished to _ through only and does not cover any retentions retained before or after the release date; extras furnished before the release date for which payment has not been received; or extras or items furnished after the release date. Rights based upon worl performed or items furnished under a written change order which has been fully executed by the parties prior to the release date are covered by this release unless specifically reserved by [lie Claimant in this release, This release of any mechanic's lien, stop notice, or bond right shall not otherwise affect the contract rights, including rights between parties to the contract based upon a rescission, abandonnle it, or breach of the contract, or the right of the Undersigned to recover compensation for furnished labor, services, equipment, or material covered by this release if that 1 furnished labor, service ,equipment, or material was not compensated by the progress payment. Dated; (Contractor) By (Prins Name) ('Title) EXHIBIT C-2 ONDITIONAL WAIVER AND RELEASE UPON FINAL PAYMENT Upon receipt b) the Undersigned of a check from _ �_____in the (Maker of Check) SUM of$__ payable to __ _and when the check (PayCe) has been properly endorsed and has been paid by the bank upon which it is drawn,this document shall become effective to release any mechanic's lien, stop notice, or bond right the undersigned has on the,job of __ located at {Ow ter) (Job Description&.Address) This release covers the final payment to undersigned for all labor, services, equipment, or material furnished on the job. B fore any recipient of this document relies on it, the party should verify evidence of payment to the unde!signed. Dated: "-- (Contractor) By ---(Print Name) 4 EXHIBIT D CHANGE ORDER 1. Number Date z. Contractor Address 3. ,fob Description 4. Property Address or Legal Description: 5. Contractor hereby agrees to make the change(s) speeiftedbelow: See Attaclunent"A" _—�._..... 6. Fixed Price of Ch nge(s) Add: $ Deduct: _ 7. Previous Change Orders $ S. Reason for Change: See Attachment"A" 9. Contract Time Extension: 10. New Completion ate: ACCEPTANCE. The terms of this change order are satisfactory and are hereby accepted: OWNER APPRC VAL, _ DA'Z'E CONTRACTOR APPROVAL DATE., _ Attachment"A" Change Order No. Initial Construction Control Document M To be submitted with the building permit application by a R Registered Design Professional aV for work per the 8t" edition of the �a Massachusetts State Building Code, 780 CMR, Section 107.6.2 Project Title: 440 Great Pond Road Residence Date: January 31, 2017 Property Address: 440 Great Pond Road, North Andover, MA Project: Check(x)one or both as applicable: New construction X Existing Construction Project description: The roject is to construct a single family residence at 440 Great Pond Road. The project was started in 2003 and pro¢ressed at differebt intervals The current owner is looking to complete the interior of the existing framed building The work will include electrical plumbing HVAC and interior cabinetry and millwork. I Thomas F. Galvin MA Registration Number: 20285 Expiration date: August 31,2017 , am a registered design professional, and hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: X Entire Project Architectural Structural Mechanical Fire Protection Electrical Other: for the above named project and that such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code,(780 CMR),and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review,for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. When required by the building official, I shall submit field/progress reports(see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work, I shall submit to the $' 1 a `Final Construction Control Document'. Enter in the space to the right a"wet"or Q�,� ��lPS F Gyp <`�,� electronic signature and seal: no No.2.0285 cn WAUIn A 96R. Phone number: 978-470-3675 q t� rassearchitects.com Building Oficial Use Only Building Official Name: Permit No.: Date: Note 1.Indicate with an`x'project design plans,computations and specifications that you prepared or directly supervised. If`other' is chosen, provide a description. s die cgmmonweafth of,i dssach08tt-9 _ Department of indastrialAccidents z 1 Co,Ytgress meet,so` 100 - B 0. 114 2017 Boston w www mass•go-v1dia Wakers' Compensationxnsnxance•�idavit: ,dexs/Cox�t�'acto�rsll+;iectricza�usl�Xmmbers. pleasePrint L I A ' li mn'Tnfo anion CON C N•amt(Bushawdo ari atioz�/I�diviclual}= Address: N L� City/State/Zip: r✓. . :. .. � ° Tt7teb°A: Tyi7B oi�l►xo�eet(�ecZnoxad)= • Areyotr an ezrsgXoper2 gLaclrth.e aper P 7.[�I arae emgl°yer with empl°yam (fan and/or part-[ane}� 'l, Q lge'�'CO]]#iftdd 10R andhavenaeft mgl(]Ywz- DAft formein 8. �Remode. 2.Q I am a solepropriefor oz paztnetshiP . any capacity.PTO worlmle comp.iusumnee requil l 9. �D ern olztion ancere ukectl' 10[�$u31d addition 3.[]I am ahomwgmDr doing a1.1•wozlcmyse3£fbT workers'comp.insnr q eow3aer,UaWllbebidang,,*aetus�toeonduotaUvrorlcori.mgFrOPD Iv+� 1I.F]mectricalTep,$�Tsora-dffitions 4.Q I=a bpm ensation ins�uanne oz are sole , �zrethat alt eoatagfois aifiierl3ave•workers'comp j2xVF u�xbing repairs ox additxow propdetozayWfthno'a layer• the aub-contactors listed onthe attached sheet. 13,.[]Roof repairs 5_m I am a general conugoto;aucl ,have hired insurane0 nesesub-om�ttaeEozs ZaveempInyeesendhavewc�cers'carne• Other e exercisedtheizright emPd0n3?erMGL c. fi sndzts•o�au3,haF nfb7c ed 6. V1e are a cozpor$ es. e-Workers comp• ��r 1 Qsud`�tebavano amplaS'd. CN x# must also tlli out the sectionbelov�showingtheirwoxkers'compensation.pohCym�rmation- *A ny-Anyelil�orkandthenhireo�deconb=torsauustsubmifanervafiidav indicat€ngat fHomeuwoerswhosu13mittivsaiiidavk���Ysre`� the�nameofthes°b-oon�actorsand.s[af whglherCL o�Cnotihase,entites have Contrantozs tient chaokthis Bl6.x_fnusf atta-hed'an additional sheetshowing the sub-co�actorshave empl°Yees,tibe}'must gmvidethek-toper'COmP-p°hc�` b employees. If 20 ertlzatisprovictgakers'campensar� nsraYar�ceformy employees. Bel is thepo�ie�¢rtd joa'sit� Z am an emp y infar�natian. � G Iusuxanco Com.PMy dame; _FxpirationDatez L 0 Z Policy#or Sclf its. CxtylStaa`elZip ,-�^ no++r cn filh O t 8S To-b Site Address: - T '� .f 'Iolio n�zmber and.UPiration date). Attach a cope of he workers' coxa ensalion policy declaration gage{sho g e P liable by a�rn1r up to$1.,5 00.00 f allure in sectxxe covexaSe as remzia ed nutlet MGL o.x52,§25A- a cxi gal vzolation p and/or on sWVX impxisogO ag 1: as�ll as civil�enalti-3 i ffi.form of a STOP'WORD ORDS,and a f ae of to $250.00 a day agaisast e-telefax.A cagy o£this statementmay be forwarded to the O:M, of vestigatiax�s of theD7Afbxix iarauce coverage-verification er tli ai penalties ofperjary that the information pr'oviciecl alcove trr�e and carte .b do laereby certify P Si atuxe: Mow-)#: pjcicil rise or�Zp. Doott�xite in this area,to Tae carrapleted by city ox�io 'i octal r �ice�ase# City or Town' lssningAntho ty(circle oue): ' ector 5.P1nmToang�ector .$oaXd of3 ealth 2.DnildingDepaxianent 3.City/Toym Clerk 4.Me ctxiealXosp 6.Other phone#: Contact�.'exson: A ® DATE(MMfOD1YYYY) CERTIFICATE OF LIABILITY INSURANCE 1/3/2017 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 THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder Is an ADDITIONAL INSURED,the policy(les) 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 endorsements). PRODUCER CNAMP r Select Department E: Eastern Insurance Group LLC PHONE . (800)333-7234 x66807 F No:(781)5868244 233 West Central Street EMAIL .selectwork@easterninsurance.com INSURER(5)AFFORDING COVERAGE NAIC# Natick MA 01760 INSURER A Arbella protection Ins. Co. 41360 INSURED INSURER B:Technolo Insurance Co. 42376 DC Development & Construction LLC INSURERCAllmerica Financial Benefits 41840 c/o Stephen Doherty INSURER D: 100 bale Street INSURER E: Haverhill MA 01830-3972 INSURER F: COVERAGES CERTIFICATE NUMBERMASTER 16-17 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 TYPEOFINSURANCE ADD POLICY NUMBER MWDDDIYYYY CY EFF CY LTR IYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea Mroncel TED $ 100,000 A CIAIMSAIADE OCCUR 8500060926 0/29/2016 0/29/2017 MEDEXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY PAO LOC $ AUTOMOBILE LIABILITY COMBINED 0 UTLIMIT 11000,000 ANY AUTO BODILY INJURY(Per pemon) $ A ALLOWNED X SCHEDULED 1020001146 /23/2016 6/2312017 BODILY ni) JURY(Peracdde AUTOS AUTOS / $ X eOR DAMAGE ED (Massachusetts) $X HIRED AUTOS NO OS PROPERTY Medlcal payments $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION X O STATU- 0. AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE� NIA E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? C3465254 /15/2016 /19/2017 $ (Mandatory in NH) EL.DISEASE•EA EMPLOYE $ 100 000 If destiibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 C Automobile 9812931 1/1/2016 1/1/2017 Combined Singis Limit $1,000,000 Scheduled/Hired/Non-Owned T (New Hampshire) DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Addltlonai Remarks Schedule,If more apace Is required) EXCAVATION CONTRACTOR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover 120 Main Street North Andover, NA 01845 AUTHORIZED REPRESENTATIVE John Koegel/PKG ACORD 25(2010105) ®1988.2010 ACORD CORPORATION. All rights reserved. INS[125nn1nn.Fn ns Tho Ar:npn mama mnri Inn^ara ranletarorl marira of Arnpn i Office of Consumer Affairs and Business Regulation 10 Park Plaza- - Suite 5170 Boston, Massachusetts 02116 Home Improvement Ccubactor Registration --� w Registration: 172892 Type: LLC DC DEV Expiration: 8/8/2018 Tr# 419291 DEVELOPMENT & CONSTRUC3 STEPHEN DOHERTY Pk 100 HALE ST HAVERHI LL, MA 01830 Update Address and return card.Mark reason for change. SCA; 20M-o5in Address [I )Renewal [I Ernployment Lost Card �� L%fce Cpomrr,¢4ru �o�C�/�La.GaacvicG,e�t # Office of ConsumerA6fairs&Business Regulation License or rea stration valid for individual use only l - HOME IMPROVEMENT CONTRACTOR before the expiration date, If/Quad return to: Registrat9ar► `'.172892 Type: Of£ce of Consumer'Affairs and Business Regulation Expiration3. 8 LLC 10 Park Plaza-Suite 5170 ]Boston,MA 02115 DC DEVELOPMENT` �?NS:9W!.GTION LLC STEPHEN DOHE� .== 100 HALE ST - HAVERHIU-W 01830 - Undersecretary Not valid without signature Massachusetts Department of Public Safety Board of Building,Regulations and Standards License: CS-037817 Construcaian SuperVisor STEPHEN J DOHERTY 100 HALE STREET HAVERHILL MA 01830 (�•nn l�� Expiration:' Commissioner 10/27/2017 s