HomeMy WebLinkAboutBuilding Permit #910 - 667 SALEM STREET 6/18/2012Permit NO:
Date Issued:
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
IMPORTANT:
I TYPE OF IMPROVEMLN I
❑ New Building
❑ Addition
❑ Alteration
KRepair, replacement
❑ Demolition
A
cr
OWNER: Name. -
Date Received
cant must
PROPOSED USE
Residential
)lq)ne family
❑ Two or more family.
No. of units:
❑ Assessory Bldg
❑ Other
ESCRIPTION OF WO
hc; kr�erS
Identification
all items on this
Non- Residential
❑ Industrial
Q Commercial
❑ Others:
C O BE PREFORMED:
/1d0%h o�
ie Type or Print Clearly)
r L_ -e Phone: r%✓S'� ,
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ARCHITECT/ENGIN
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" - O '� _FEE: $ �� .6 1
Check No.: %e,5 Receipt No.: rZI 2
NOTE: Persons contractingwith unregcoered contractors do not have access to the guaraound
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
a 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
o 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 2.2007
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer
Tanning/Massage/Body Art ❑
Swimming Pools ❑
Well ❑
Tobacco Sales ❑
t
Food Packaging/Sales ❑ t
Private (septic tank, etc. ❑
Permanent Dumpster on Site ❑
a
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ 1' h '- /—) , / �)
COMMENTS
0
HEALTH
COMMENTS
DATE
El
ECTED DATE APPROVED
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Z
Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature & Date Drivewav Permit
Located at 384 Osgood Street
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
Doc.Building Permit Revised 2007
Location6 1� -%elf
No.— 2.16 Date
Lz
Check #-Z "J,
25428
TOWN OF NORTH ANDOVER
Certificate of Occupancy
Building/Frame Permit Fee
Foundation Permit Fee $
Other Permit Fee $-
TOTAL $
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IN
RED TAIL CONSTRUCTION
CONTRACT PROPOSAL
Prepared for:
Denise Roche
667 Salem st
North Andover, MA- 01-945
4/24/2012 Contract Proposal - Page 1 of 15
Dear Denise,
We are pleased to offer for your consideration the following proposal for the construction of your project. For ease
of reference, this proposal is divided into the following sections:
Section I
Contract/Proposal
Business conditions
Section II
Contract/Proposal
Construction Contract
Section III
Attached Booklet I
Specifications of the job
The description of the proposed project contains precise, but understandable specifications (Section III) of
the items which are included in your project. The specifications form the heart of any construction
CONTRACT and we ask that you review them carefully. IF IT IS NOT SPECIFIED IT IS NOT INCLUDED IN THE SCOPE
OF THIS PROPOSAL.
The business section gives you the general conditions of the work and site, the anticipated start and
completion dates, the price of the project with the payment schedule as well as any allowances.
The legal section expresses the general conditions of the CONTRACT and specifies the responsibilities of the
contractor and the owner.
The item identifier i.e. GN01001, is shown in the specifications for ease of identification of each and every item we
have included in this proposal. Remodeling work can be confusing and complex; however, hopefully this
format will facilitate your review of our proposal to insure we have included all your wishes.
We are pleased to have the opportunity to prepare this proposal for your consideration. I will be happy to
answer any questions you might have on any aspect of this CONTRACT proposal at your convenience. Red Tail
Construction is dedicated to providing the highest level of customer service in the industry. We look forward to
working with you on your project.
Sincerely,
Steve McCullo g —Owner Re ail Construction
4/24/2012 Contract Proposal - Page 2 of 15
Section
of the
Contract/Proposal
for
Denise Roche
Business Conditions
4/24/2012 Contract Proposal - Page 3 of 15
BUSINESS CONDITIONS TO THIS
CONSTRUCTION CONTRACT
This Contract, dated 4-12-12 is by and between: Denise Roche 667 Salem Street North Andover MA .
01845 (Referred to as OWNER), and Red Tail Construction, 733 North Turnpike Street Unit 192 North
Andover, MA 01845 (Hereafter referred to as CONTRACTOR). Work will be performed at 667 Salem
Street North Andover MA .01845 (Hereafter referred to as PROPERTY)
1. GENERAL
This CONTRACT is for the following work and materials to be performed by the CONTRACTOR on the PROPERTY
address shown above. The project is generally described as follows:
Create a new Kitchen area and create an open flow between the kitchen and the front fireplace/living room area;
new gas fireplace, new kitchen cabinets and tops throughout, new Anderson Frenchwood glider; all per designs
and discussions; cabinets from Plaistow cabinets. The CONTRACT consists of this document, any plans, the
specifications, and the Construction Contract. (Her�ea#e collectively referred to as the "CONTRACT")
2. PRICE f.
The total price for the WORK agreed up(n is $4000.00. P ent terms are set out below in Paragraph 6.
3. STARTING AND COMPLETION PROVISIONS
The WORK will begin approximately in the early part of the week of April 23`d 2012 and will be completed, absent
unusual or unforeseen circumstances, in the 2nd week of May 2012, providing this CONTRACT and any
related CONTRACT documents are accepted when presented. The aforementioned dates reflect our present
workload. Projects are assigned a slot in our work schedule as they are accepted, on a first come first served
basis. These dates may move based on the completion time of the project that immediately preceded yours.
4. APPLICABLE CODES: COMPLIANCE WITH LOCAL LAW
All work to be done under this CONTRACT will be in accordance with local, state and county building
code. All home improvement contractors/subcontractors working in the state of Massachusetts must be
licensed and registered by the Bureau of Building Regulations and Standards. All inquiries concerning the
CONTRACTOR should be transmitted to that office. In Massachusetts, Red Tail Construction operates
under License number CS094338 and Registration #155649.
124/2012 Contract Proposal - Page 4 of 15
5. SPECIFIC REQUIREMENTS FOR MATERIALS AND WORKMANSHIP
This CONTRACT will be completed by the CONTRACTOR in a good and workmanlike manner, using first-class
materials.
If applicable, the CONTRACT price includes the following allowances: (See allowances under
specifications).
6. PAYMENT
Timely payment by the OWNER of all sums due under this CONTRACT is of the essence to this CONTRACT.
The parties agree to the following schedule of payments:
Milestone
Payment
Upon Signing Contract
$1000.00
Start of Installing new stairs
$2,000.00
Completion of Project
$-,000.00
Notes: Plumbing not included in the above amounts.
The CONTRACTOR may cease operations if any payment is not made by the OWNER as required herein,
and proceed to collect any balance due through any remedy provided by law. Payments are due when the
aforementioned progress milestones have been reached. It is understood that minor adjustments to the
payments schedule may be necessary due to the flow of work or delays beyond the control of the CONTRACTOR.
7. DEFINITIONS
Substantially complete - The space or project is substantially complete when the space or project can be used
for its intended purpose and only punch list items remain.
Punch list - Work or product that has not been performed or provided. Punch list items will be agreed upon
by both the CONTRACTOR and OWNER. The OWNER requests responsibility for maintaining and
approving completed punch list items. The final payment will be subject to final inspections being
completed and having an updated occupancy permit.
Warranty item - A product or service that has been provided or performed that does not meet or exceed
industry standards.
THESE CONDITIONS MUST BE ACCOMPANIED BY THE CONSTRUCTION CONTRACT
4/24/2012 Contract Proposal - Page 5 of 15
Section II
Construction Contract
of the
Contract/Proposal
for
Denise Roche
4/24/2012 Contract Proposal - Page 6 of 15
CONSTRUCTION CONTRACT
This Contract is by and between:
Denise Roche 667 Salem Street North Andover MA .01845 as "OWNER", and Red Tail Construction as
the "CONTRACTOR" for work at 667 Salem Street North Andover MA .01845
1. CONTRACTOR'S DUTIES -- GENERAL
a. To direct and control the work contracted for in accordance with the terms of this CONTRACT and all
applicable codes, laws, and regulations, and as the building permits issued for this project, if any, require.
b. To inspect the site, examine the plans and specifications, if any, and supervise all of CONTRACTOR's
employees, and to direct the work of all subcontractors selected by CONTRACTOR. Should the
homeowner recommend a specific designer for the new kitchen, Red Tail will "team up" with the
prospective kitchen designer so that all dimensions, layout details, and quality of workmanship, are in
keeping with the homeowner's goals and objectives. It should be noted that the work related to this project
would be completed under Red Tail's permit and license.
c. To maintain the work site in a safe and clean condition, to the extent consistent with the CONTRACT.
d. To advise the OWNER promptly if concealed conditions are ascertained which require additional or
different work, and to proceed in such event in accordance with this CONTRACT.
e. To provide locked storage for any equipment, tools, or other PROPERTY used in the performance of this
CONTRACT, unless otherwise agreed in writing.
2. OWNER'S DUTIES -- GENERAL
a. To provide adequate utilities for the work agreed upon.
b. To advise the CONTRACTOR of any condition of the PROPERTY which affects CONTRACTOR's ability to
perform.
c. To provide secure storage areas for materials delivered to the work site. This simply means that we will
ask to store construction materials and supplies on your site—mostly in the backyard. It is recommended
that we have the ability to store some tools in the lower level of the new basement area when this area is
created. When doors, windows, cabinets, and generally anything of value, require storing on site, we'll
ask if we can use the garage bay area for temporary and a more secure storage area.
d. OWNER shall be entitled to make periodic inspections of the work site, provided such inspections do not
interfere with the work and can, in the judgment of the CONTRACTOR, be made safely. Any other entry
onto the construction site shall be at OWNER's risk.
4/24/2012 Contract Proposal - Page 7 of 15
e. OWNER shall notify his insurance agent of the execution of this agreement and obtain any necessary
riders to his current coverage or any locally customary forms of coverage, such as builder's risk, to cover
OWNER's interests and liabilities during the construction process.
f. To perform no work on the project without a written agreement with the CONTRACTOR.
g. To make no agreements with any trades person, subcontractor, or CONTRACTOR'S employees outside
the scope of this CONTRACT without the written consent of the CONTRACTOR.
3. MATERIAL SUBSTITUTION
CONTRACTOR reserves the right to substitute other materials, products and/or labor of equal or superior
quality, utility, or similar color. This simply means, for example, that if 2X10s are not available on the
market, then we'll use 2X12s. This type of flexibility in the field allows your project to continue on expected
timelines rather than stop the project and wait for a precise material to become available. There will be no
sub -standard materials or products used at any time during the scope of your project.
A DFI AY
CONTRACTOR shall not be responsible for delays caused by events beyond the control of the
CONTRACTOR, including but not limited to: strikes, war, acts of God, riots, governmental regulations
and restrictions. Delays caused by OWNER'S failure to make allowance materials selections or caused by
the performance by CONTRACTOR of extras or necessary work (as described in Paragraph 6) shall likewise be
excusable delays.
5. INSURANCE
CONTRACTOR agrees to maintain all necessary forms of insurance to protect the OWNER from liability
for any occurrence arising from the performance of this Contract. The OWNER requests copies of the
CONTRACTOR'S general liability insurance binders showing at least one million dollars of coverage; the
binders must include the OWNER'S names to indicate protection for the work done under this CONTRACT.
CONTRACTOR agrees that he shall cover his own employees for worker's compensation and carry
general liability insurance, and that all forms of insurance referenced herein shall be with reputable
companies licensed to do business in the state where the project is located.
6. HIDDEN. CONCEALED and UNFORESEEN CONDITIONS
a. The parties agree that in the event CONTRACTOR discovers a hidden, concealed or unforeseen
condition requiring an extra cost that they shall proceed as follows: The CONTRACTOR shall notify the
OWNER verbally to expedite agreement as to any charge necessary to correct or cure such condition,
and provide a written Work Order (as described in paragraph 7a) as soon as practicable. The parties
must agree to such extra charges, or agree to a resolution method, or this CONTRACT may be cancelled by
either of them.
4/24/2012 Contract Proposal - Page 8 of 15
b. For purposes of this section, a "hidden, concealed and unforeseeable condition" shall mean a condition
not readily observable to a prudent CONTRACTOR inspecting the subject PROPERTY for the purpose of
performing this Contract. Examples of such conditions can include, but are not limited to; rot under siding;
ledge below grade; pre-existing plumbing or electrical work not performed to code and pre-existing mold.
c. Any change in the WORK required by building officials assigned to this project, including structural
and/or any environmental hazards will be billed as an EXTRA charge to this CONTRACT and paid for
by the OWNER as a Work Order. CONTRACTOR may cease operations if OWNER refuses to pay. Red Tail at
a MINIMUM adheres to the Official Massachusetts Building Code Blue Book, for all code related and acceptable
building standards per the State of Massachusetts. The local building departments are required to simply enforce
those standards, yet no more than those standards. Red Tail has not had any negative experiences in this domain,
and typically confirms any ambiguous areas of a project with the local building department prior to proceeding with
construction areas that may become suspect. If any segment or parts of your project are not completed in
accordance to code, then it is Red Tails responsibility to remedy the suspect area into code compliance. The
Building License and Home Improvement Contractors License, held by Red Tail, each ensure that Red Tail is
knowledgeable with and compliant with Massachusetts State Building Codes.
a. Any extra work or materials desired by the OWNER shall be agreed upon in writing and such extras
shall become a part of this CONTRACT as if fully set forth herein. Unless otherwise agreed, extra work shall
be paid for as performed.
b. CONTRACTOR shall advise OWNER, at the time of agreement on an extra, as to any additional time
required to perform this CONTRACT.
8. ESCALATION
CONTRACTOR reserves the right to pass on additional costs to OWNER resulting from the escalation of
the cost of lumber or lumber byproducts. This cost may be passed on only, if after the CONTRACT is signed
but before the construction commences, an increase in lumber costs is experienced. The CONTRACTOR
must substantiate the change with evidence of the difference between lumber costs at the time of the
CONTRACT and lumber costs at the time of construction. Only direct cost differences may be passed on,
no allowances for overhead and profit shall be included. Any additional costs will be collected per Work Order
(as described in paragraph 7a.).
9. EXCESS MATERIALS ON SITE
CONTRACTOR routinely stores extra materials on site to improve efficiency and reduce the likelihood of
running out of stock in the middle of a task. Unless otherwise specified in writing all excess materials on
site at the end of the project are the PROPERTY of CONTRACTOR.
10. SUBCONTRACTORS
4/24/2012 Contract Proposal - Page 9 of 15
a. CONTRACTOR shall select subcontractors as required to complete this CONTRACT. OWNER
acknowledges that subcontractors will do various portions of the work. Any subcontractor selected by
the CONTRACTOR shall have all requisite licenses for the work to be done by such subcontractor.
b. It shall be the duty of the CONTRACTOR to use reasonable care in the selection of subcontractors.
Absent objectionable performance by any subcontractor, the selection of subcontractors shall be an
exclusive right of the CONTRACTOR. The CONTRACTOR shall require all subcontractors to have
workman's compensation and liability insurance in force.
c. CONTRACTOR shall pay subcontractors in a timely manner and obtain from subcontractors any
necessary documentation required to release their liens, if any, as the work proceeds. Red Tail will provide
the homeowner with copies of lien releases.
11. TERMINATION AND CANCELLATION
The CONTRACTOR may terminate and cancel this CONTRACT if any payment called for hereunder is not
received as scheduled, provided that notice is given to the OWNER as provided below. Upon such
termination, the CONTRACTOR shall have all remedies provided by law, including such lien rights as then apply.
The OWNER may terminate this CONTRACT upon the following conditions:
a. Failure of the CONTRACTOR, or his subcontractors, to pursue the work contracted for, absent
excusable delay, as provided in Paragraph 4 above, for a continuous period of seven (7) days,
without a written agreement permitting same, such agreement may be satisfied by a single notation to this
b. Failure of the CONTRACTOR to rectify any condition for which building code enforcement authority has
issued a citation of violation notice, within seven (7) days notice of such violation, unless OWNER
and CONTRACTOR otherwise agree.
c. Any other failure to perform this CONTRACT required by the terms of this CONTRACT.
d. No termination shall be effective unless 5 days notice of OWNER's intent is given as required below,
during which time the default may be cured by the CONTRACTOR.
e. Deposit monies - Cancellation of this CONTRACT prior to the commencement of work shall result in the
forfeiture of any and all deposit monies collected. All deposits are non-refundable. The parties hereby
agree that upon such cancellation, the CONTRACTOR shall suffer damages including but not limited to
the cost associated with designing and preparing the project for commencement.
4/24/2012 Contract Proposal - Page 10 of 15
f. You may cancel this agreement by observing the requirements of The Notice of cancellation you have
received. Red Tail will at contract signing provide you with a Notice of Cancellation document. This gives
you a 3 -day right of rescission period should you change your mind after signing the contract.
g. If a dispute arises out of or is related to this Contract, or the breach thereof, the parties shall endeavor
to settle the dispute first through direct discussions. If the dispute cannot be settled though direct
discussions, the parties agree the dispute shall be settled by arbitration administered by a mutually
agreeable Alternate Dispute Resolution provider; absent agreement to an ADR provider, the American
Abitration Association will be used. In the event that arbitration is necessary, the parties agree that
arbitration proceedings shall be conducted by a mutually agreed on arbitrator in Middlesex County,
Massachusetts. If the parties cannot agree on an arbitrator, either party may file a written demand for
arbitration in accordance with the rules of the American Arbitration Association. The arbitration
award shall be final and judgment on the award may be entered in any court having jurisdiction thereof.
This CONTRACT shall be governed and interpreted in accordance with the laws of the State of
Massachusetts. The parties acknowledge that this agreement to arbitrate shall be governed the
Massachusetts Statutes- MGL c. 142A. Either party may, without waiving any remedy under this
CONTRACT, seek from any court having jurisdiction any interim or provisional relief that is necessary to
protect the rights or PROPERTY of that party, including but not limited to the right to seek liens or
attachment. The prevailing party in any dispute arising out of or relating to this CONTRACT or its breach
that is resolved by a binding dispute resolution process shall be entitled to recover from other party
reasonable attorneys' fees, costs and expenses incurred by the prevailing party in connection with such
dispute resolution process.
R- - ---- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - -
Denise Roche Steve McCullough - C>`/vner Red T Construction
Notice: The signature of the parties above constitutes an acknowledgment of the agreement
between the parties to alternative dispute resolution. Massachusetts consumers may have the right to
initiate alternative dispute resolution even where this section is not signed by the parties.
h. Unless otherwise agreed in writing, CONTRACTOR shall continue the WORK and maintain the agreed
work schedule during any dispute resolution proceedings. If CONTRACTOR continues to perform,
Owner shall continue to make payments in accordance with this Contract.
12. ENVIRONMENTAL HAZARDS
a. The CONTRACTOR is NOT responsible for the inspection, discovery, abatement or removal of any
environmental hazard including, but not limited to: asbestos; mold; lead; radon; ground water or
environmental pollution at the work site, unless specifically covered in the specifications.
4/24/2012 Contract Proposal - Page 11 of 15
b. In the event that any hazardous material is discovered during the course of construction, the testing,
abatement and/or removal shall be shall be the sole responsibility of the OWNER.
c. Any additional costs incurred on account of suspension of the construction or changes to the
specifications due to a hazard or its removal are the responsibility of the OWNER and will be handled by a Work
Order.
d. In the event that work does not resume within 30 days of the stoppage, OWNER agrees to immediately pay the
CONTRACTOR the pro -rated amount of the CONTRACT price applicable to work done up to that point
pursuant to the Contract.
WARRANTY
OWNER warrants that as of the date of this CONTRACT: 0) the PROPERTY (including the land, surface water,
ground water, and improvements to the land) is, and will continue to be, free of all contamination, including (a) "oil,
petroleum products, and their by-products" (b) any "hazardous waste" as defined by the Resource Conservation and
Recovery Act of 1976, as amended from time to time, and regulations promulgated thereunder; (c) any "hazardous
substance" as defined by the Comprehensive Environmental Response, Compensation, and Liability Act of 1980, as
amended from time to time, and regulations promulgated thereunder, specifically including asbestos and mold; and
(d) any other "hazardous substance" (2) the PROPERTY is in compliance with all environmental laws and regulations;
and (3) there are no underground tanks on the PROPERTY
INDEMNITY
OWNER expressly acknowledges and agrees that it will reimburse, defend, indemnify and hold harmless
CONTRACTOR, all Sub -contractors, their successors, assigns and employees from and against any and all
liabilities, claims, damages, penalties, expenditures, losses or charges (including, but not limited to, all costs of
investigation, monitoring, legal fees, remedial response, removal, restoration or permit acquisition) which may, now
or in the future, be undertaken, suffered, paid, awarded, assessed, or otherwise incurred as the result of:
(a) any contamination, existing in, on, above or under the PROPERTY (including, but not limited to, contaminated
soil, mold, buildings, facilities and/or ground water);
(b) any investigation, monitoring, clean up, removal, restoration, remedial response or remedial work undertaken on
the PROPERTY; and
(c) OWNER'S breach of any warranty given herein.
13. WARRANTIES
a. The work of the CONTRACTOR, including materials and labor, shall be under warranty for a period of
one 0) year, during which period CONTRACTOR shall at its own expense correct any defect arising from its
work unless it is a non -warrantable condition. The warranty period begins at the end of the Completion of
Punch list stage.
4/24/2012 Contract Proposal - Page 12 of 15
b. Any and all warranties for appliances or mechanical systems shall be delivered to OWNER as the
CONTRACTOR receives them.
c. Notwithstanding any manufacturer's warranty of any component, appliance, or system, no action may
be brought against the CONTRACTOR on this CONTRACT for the performance of this work, except as
provided above.
14. SEVERABILITY
If any portion of this agreement is found invalid or unenforceable by any court, the remaining provisions shall
remain in force between the parties.
15. ENTIRE AGREEMENT
This CONTRACT consists of the documents defined herein, and constitutes the entire agreement of the
parties. It can be modified only by a written document. OWNER acknowledges that he has read and
received a legible copy of this agreement signed by CONTRACTOR, before any work was done, and that
he has read and received a legible copy of every other document that OWNER has signed during the
negotiation of this Contract.
SUBMITTED:
Steve McCullough
Red Tail Construction
ACCEPTED:
--- -----------U----- ------------------
Denise Roche
DATE:
DATE:_
4/24/2012 Contract Proposal - Page 13 of 15
Section III
Attached Booklet
to the
Contract/Proposal
for
Denise Roche
Job Specifications
4/24/2012 Contract Proposal - Page 14 of 15
As part of this contract for illustrative purposes, there are kitchen Designs and illustrative drawings.
These specifications outline your entire project as priced in this proposal. If there is wont that you want performed and
it is not listed in this proposal it is not included and you have not paid for it in the contract price. Please review these
specifications carefully.
Client initials
New stairs for entrance
Install new stairs with composite surface boards and composite rails
4/24/2012 Contract Proposal - Page 15 of 15
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Information and Instruction's
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract ofhire,
express or implied, oral or written."
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
of the foregoing engaged in a j oint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states that "every state or Ideal licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced.acceptable evidence of compliance with the insurance coverage required"
Additionally, MGL chapter 152, §25C(7) states `Neither the commonwealth nor any ofits political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if
necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificates) of
insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not required to carry workers' compensation insurance. Iran LLC orLLP does have
employees, a policy is required. Be advised that this affidavit maybe submitted to the Department of .Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy, please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current
policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or
town)" A copy of the affidavit that has been officially stamped or marked by the city or town maybe 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. More a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc) said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address, telephone and fax number:
Tho Com
aOuwealthofMassacl?vsPfts
Dep.axtent o0 dustdat +A racldonts
office ofIuvestigatIO)n
60 WashiWoa Street
Boston? MA, 021 X Z
TQL # 617-727-4900 ext 406 or 1-877 ,SSAFE
Revised 5-26-05 FaY, # 617-727-7749
WWW-Mass,gov d'a.
The Commonwealth of Massachusetts -
Department ofIndustriglAccidents
Office oflnvestigations
600 Washington Street
.Boston, MA 02111
www.massgovMa
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
� r
Name (Business/Organization/individual): (hc l co
Address:_ 3,?
City/State/Zip: A)09'" A% Phone #: q28 . 73 - tl -? ? 7
Are you an employer? Check the appropriate box:
Type of project (required):
Al am a employer with I
4. ❑ T am a general contractor and I
6. ❑ New construction
employees (full and/or part time).*
have hired the sub -contractors
7. (Remodeling �iC
2. ❑ I am a sole proprietor or partner-
listed on the attached sheet. x
ship anThave no employees
These sub -contractors have
8. ❑ Demolition
working for mein any capacity.
workers' comp. insurance.
g, El Building addition
[No workers' comp. insurance
5. El We are a corporation and its
10.❑ Electrical repairs or additions
required.]
officers have exercised their
3111 1 I am a homeowner doing all work
right of exemption per MGL
11.[] Plumbing. repairs or additions
myself. [No workers' comp.
c. 152, §1(4), and wehave no
12.0 Roof repairs
insurance required.]
employees. [No workers'
13.❑ Other
comp. insurance required.]
"Any applicant that checks box #I must also fill out the section below showing their workers' compensation policy information.
Homeowners who submit this affidavit indicating they $•re doing all work and then hire outside contractors must submit anew affidavit indicating such.
?Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information.
I am an employer that is providing workers' compensation insurance for my employees Below is thepolicy and job site
information. I-rr
Insurance Company Name:. "Ire
Policy # or Self -ins. Lic. #.
V LfZd
0 7/t/ 76— ` —A Expiration
20 ) 3
fao,c4
Job Site Address; J 4t A d/ City/State/Zip: Xt v7�0%V_ A q
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as requiredunder Section 25A of MGL o. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisonment, as wellas civil penalties in the form of a STOP -WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
Ido hereby cert& under the,
that the information provided above 1s true and correct.
�212/!.)L
IP73 -=
Official use only. Do not write in this area, to be completed by city or town official.
City or Town: _ Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other - - -
Contact Person: Phone
ACORQ CERTIFICATE OF LIABILITY INSURANCE
DATE D/YYYY)
(MMID04/24/2012
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 endorsement(s).
PRODUCER
New England Heritage Insurance Agency Group, Inc.
335 Main Street
Stoneham, MA 02180
CONTACT
NAME:
A/CNoExt:781.438.5000(AIC Ne:781.438.5028
ADDRESS:
INSURERS) AFFORDING COVERAGE MAIC #
INSURERA: National Grange Mutual 14788
INSURED McCullough, Steve
DBA: Red Tail Construction
733 Turnpike St. Unit 192
North Andover, MA 01845
INSURERS; Travelers Indemnity Co. 25658
INSURERC:
INSURER D:
E:
-INSURER
INSURER F:
COVERAGES CERTIFICATE NUMBER: Master 12 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.
LTR
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
MM/DD
MMIDD
LIMITS
A
GENERAL LIABILITY
is COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE [X] OCCUR
MP11010
07/03/2011
07/03/2012
EACH OCCURRENCE $ 1,000,000
PREMISES (Ea occurrence) $ 500,00(
MED EXP (Any one person) $ 5,00(
PERSONAL &ADV INJURY $ 1,000,00(
GENERAL AGGREGATE $ 2,000,00(
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JECOT- LOC
PRODUCTS - COMP/OP AGG $ 2,000,00(
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIREDAUTOS AUTTOSSWNED
COMBINED SINGLE LIMIT
Ea accident $
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE
(Per accident) $
UMBRELLA LIAB
EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE $
AGGREGATE $
DED I I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, DESCRIPTION OF OPERATIONS below
N / A
6KUB0607N76-4-1
04/09/2012
04/09/2013
- -
TORY LIMITS ER
EACH ACCIDENT $ 500,00(
E.L. DISEASE - EA EMPLOYEd $ 500,00(
E.L. DISEASE - POLICY LIMIT 1 $ S00'00(
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required)
ontractor. Subject to the terms, conditions, endorsements and exclusions on the policy.
CERTIFICATE HOLDER CANCELLATION
Denise Roche
667 Salem Street
Norah Andover, MA 01845
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
Will
All rinhtc rPcPrvari
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
0
0
01
NOTES:
1. PROPERTY LINES FROM PLANS AND DEEDS OF RECORD.
2. SEE TOWN OF NORTH -ANDOVER MAP #65, LOT #49.
FOR SITE.
3. ZONING IS R-3.
4. SEE DEED BOOK #3125, PAGE #060 FOR SITE.
APPROVED BY THE TOWN OF NORTH
ANDOVER ZONING BOARD OF APPEALS
DATE
-+-a n, -7."(1d
#657
1-1/2 STY
WT.F.
KEVIN S.. & JANICE A.
BRIGHTMAN
MAP 65, LOT 50
SALEM STREET
FOR REGISTRY USE
to
40.8'
39.7' #667
— EXISTING
z 1-1/2 STY
a W.F.D.
Q h-
ao
Q DECK
1 STY
a GARAGE
39.3' 14
ori
BURGESS M. & MILDRED U.
SPICER
MAP 65, LOT 32
MAP 65, LOT 50
o AREA=27,464 S.F.
=0.63 AC.
139.00'
JOSEPH A. & MICHELE J.
SARCIA
MAP 65, LOT 52
"I HEREBY CERTIFY THAT THE PROPERTY LINES
SHOWN ON THIS PLAN ARE THE LINES DIVIDING
EXISTING OWNERSHIPS, AND THE, LINES OF THE
STREETS AND WAYS SHOWN ARE THOSE OF PUBLIC
OR PRIVATE STREETS OR WAYS ALREADY
ESTABLISHED, AND THAT NO NEW LINES FOR
DIVISION OF EXISTING OWNERSHIP OR FOR NEW
WAYS ARE. -SHOWN AND THI'S PLAN CONFORMS TO THE
RULES AND REGI 'Q4S OF THE REGISTRY OF DEEDS."
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/08./03
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STEPHENL.S. DATE
lk0uNt LAN`,."
s�
SHED
.PLAN OF LAND
IN
NORTH ANDOVER, MASS
PREPARED FOR
DENISE & RICHARD ROCHE
667 SALEM STREET
NORTH ANDOVER, MA
40 0 40 80
SCALE: 1 "=40' DATE: SEPTEMBER 8, 2003
h� 'K Ei1i rXEMM ,S'ERUCRS
68 PARK S7RE
ANDOVER. M4SSAC ZMl7TS 01.810
TEL (978)
475 3�6