HomeMy WebLinkAboutBuilding Permit #292-13 - 72 SUGARCANE LANE 9/30/2013 I RE �1ORTH q
BUILDING PERMIT o?0
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TOWN OF NORTH ANDOVER t
APPLICATION FOR PLAN EXAMINATION "
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Permit NO: r. Date Received
�9SS-Teo NU`��t�y
Date Issued:
IMPORTANT: A2pficant must complete all items on this page
LOCATION-7 a s,u- c,cccsnP Lc-_,-,_e_
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PROPERTY OWNER Jo,,,\ o,.nrSl
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MAP NOT ; PARCEL: ZONING DISTRICT: Historic District yesno
Machine Shop Village yes (no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building XOne family
❑ Addition ❑ Two or more family ❑ Industrial
'Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
Septic 17 Well ❑ Floodplain ❑Wetlands ❑ Watershed District
E Water/Sewer
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Identification Please Type or Print Clearly)
OWNER: Name: 30\ C_rg Sok' Phone:
Address: _7oZ c.SC.c,^.Q_ L z r R—
CONTRACTOR Name: Phone:
Address:
J3��� tr'lQs,r.^^C.C_�L S�'. Q`!�S .�_f (,c .J•/'¢hcfL �'+✓-�- C)��3
Supervisor's Construction License: Exp. Date:
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Home Improvement License: 7:f (9 Co Exp. Date: I a� av I S
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: $ �a�i FEE: $
Check No.: Receipt No.: 1 .
NOTE: Persons contract with unregistered contractors do not have aWesLf tdtee gVarantyfund
Signature of Agent/Owner Signature of contractor ��
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
Date Issued:
IMPORTANT: Applicant must complete all items on this page
LOCATLON° - __
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Priof_ a
f PRO_PERTY WN R, _._ - -_- i-
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Pring 100 Year=OIa;Structure yes,.p: nom
I MAP, NO' _ iPARCEL-- ZONING DISTRICT -. - Historic Dlstnct yes. ' no;
--
y iMachine Shop Village _ .yes _ no�
TYPE OF IMPROVEMENT. PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
0 Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
Septic �'UVell ; ❑ Floodplarh 0 Wetlands, ❑. Watershed`Digtnct}
Watar/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
P
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Identification Please Type or Print Clearly)
OWNER: Name: Phone:
Address:
CONTRACTOR} Name -- -_-_ -__ - -Poore
_ --- - - -
- — - -- -
,Address:
4
S;upervisor's Construction Llcen e — _- f = Exp.,
- -� r= - _
H_o_me Imprpement License '__ -_�_ __ Exp., Date:
ARCHITECT/ENGINEER Phone:
I
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: $ FEE: $
s
Check No.: Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signatureof.Agent/Owner�'_ ._; __1_ Slgaturetofrcontractor'. �
.. _�
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
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
DATE REJECTED DATE.APPR-OVED
PLANNING & DEVELOPMENT* ❑ ❑
COMMENTS
.CONSERVATION Reviewed on Siqnature
k
COMMENTS
HEALTH Reviewed on Signature
COMMENTS
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Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
d
Wates' & Sewer Connection/Signature& Date Driveway Permit
DPW To v 2 Engineer: Signature:
Located 384 Osgood Street
SIRE DEPART�IE' -`Temp Dumpster on site yes.. .. . _ no
Located at 124Mair Street
Fire"®epartrne►it signatureldate
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions._
Total land area, sq. ft.:
ELECTRICAL: Movement of Dieter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANCER ZONE LITERATURE: Yes No
MGL-Chapter-166 Section 21A-F and G min.$100-$1000.fine
NOTES and DATA— (For department use
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® Notified for pickup - Date
Doc.Building Permit Revised 2010
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Building Department
-"The following is=a list of the required forms to be filled out for the appropriate.permit to.be obtained.
Roofh-Ag, Siding, Interior Rehabilitation Permits
o- Building Permit Application
❑ Workers Comp Affidavit
Li Photo Copy Of H.I.C. And/Or C.S.L. Licenses 1
o Copy of Contract
❑ Floor Plan Or Proposed Interior Work
Li Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
Li Building Permit Application
Li Certified Surveyed Plot Plan
a Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
o Copy Of Contract
Li Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Mass check Energy Compliance Report (If Applicable)
Li 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)
Li Building Permit Application
o Certified Proposed Plot Plan
o Photo of H.I.C. And C.S.L. Licenses
o Workers Comp Affidavit
o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o 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 apw al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording
must be submAted with the building application
Doc: Doc.Buhding Permit Revised 2012
Location _ y
No. Date
. • TOWN OF NORTH ANDOVER
• Certificate of Occupancy $�
Building/Frame Permit Fee
�- Foundation Permit Fee $
'4 Other Permit Fee $
TOTAL $
Check#_ O`
26926 Building Inspector
Enter construction cost for fee cal - North Andover Fee Cakulation
Construction Cost
$ 108195.00 m
$ - $ 1,298.34
Plumbing Fee $ 162.29
Gas Fee 100 comm. $ 100.00
Electrical Fee $ 162.29
Total fees collected $ 1,722.93
72 Sugarcane Lane
292-13 on 10/1/2013
Remodel Master and Hall Bath, Laundry Room
NORTH
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S RATEO
U BOARD OF HEALTH
Food/Kitchen
PERMIT T LD Septic System
THIS CERTIFIES THAT ..........Zy. . . �......4. .�Ir1................................................. ............ BUILDING INSPECTOR
........ ...... ..
has permission to erect . buildings on !„�(A, ,, . Foundation
..... ...... ....... ...........
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to be occupied as . ...I.....601%.41m....A.....rlb.�.. � .11.r )ar&4 ......... .... Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application Final
on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and
Construction of Buildings in the Town of North Andover. + t `tow` .r J — PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
1��� •
UNLESS CONSTRUC14M S TS Rough
Service
........... ......... ................................................ Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
SEE REVERSE SIDE
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CONSTRUCTION SERVICES AGREEMENT(medium form) E
Where the basis of payment is a Stipulated Sum
Contractor: Owner: Date:
Howell Custom Buildina Group,Inc. John&Jodi Curtin 9/27/13 6
360 Merrimack St. 72 Sugarcane Lane
Lawrence,MA 01843 North Andover,MA 01845 Project Address:
Phone: 978-989-9440 978-687-2370 same
C.S.L.#068232 Project:
H.F.C.#123237 2"dFloor Renovations
I. PARTIES&DATE OF AGREEMENT
This contract(hereinafter referred to as"Agreement")is made and entered into on this
27th day of September,2013,by and between
John&Jodi Curtin,(hereinafter referred to as"Owner");and
Howell Custom Building Group,Inc.,(hereinafter referred to as"Contractor").
H. SCOPE OF WORD CONTRACT SUM &TIME }
In consideration of the mutual promises contained herein,Contractor shall perform the"Work"on the structures
and grounds at the Project Address as described in this Agreement,the following Scope of Work and any
Attachments which are incorporated into this Agreement by reference below:
A. ATTACHMENTS
1. Architectural drawings
2. Allotment.List 2 pages,dated September 27,2013
3. Substantial Completion Agreement 1 page,dated September 27,2013
B. SCOPE OF WORK&SPECIFICATIONS:
E
General Notes
• All Work shall conform to the Contract Documents as defined in the Agreement.
• All Work includes labor and materials unless otherwise noted
• Items marked Allotment Item have been included in the Contract Sum for the amount shown.
Allotment Items are to be selected by Owner and supplied by Contractor.
Owner Responsibilities '
• Owner to attend weekly project meetings on-site with Contractor. Meetings to be scheduled at a mutually
agreed upon time on a weekday between the hours of 8:00am4:30pns.
• Owner to coordinate with Contractor on planning the detailed sequence of work.
• Owner to provide information,selections and decisions to Contractor as requested by Contractor in a timely
manner so as not to delay progress of the Work.
• Owner to remove all personal items and furniture from the following Work areas:
• Master Bedroom
• Master Bath
• Master Dressing room(when needed)
+ Laundry Room
• Bathroom 42(Kids bath)
Permits&Inspections
• Contractor to prepare building permit application,file application,and post permit on-site.
• Town of North Andover Building Permit Fee.
• Plumbing Pen-nit to be obtained and the fee paid,by Contractor's Plumbing Subcontractor.
• Electrical Pernit to be obtained and the fee paid,by Contractor's Electrical Subcontractor.
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Page I of 16 Initials:
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• HVAC Permit to be obtained and the fee paid,Contractor's HVAC Subcontractor.
• Except for permits and fees noted above, the Owner shall secure and pay for other necessary approvals,
easements,assessments and charges required for construction,use or occupancy of permanent structures or
for permanent changes in existing facilities.
• Contractor to schedule and coordinate the various inspections required to complete the Work as described
in this Scope of Work.
Site Prep
General Notes:
• Contractor to provide and maintain a Portajohn on site during construction.
• Contractor to seal off existing rooms adjacent to the areas affected by demolition and construction during
the project with plastic sheeting and/or temporary wood-framed walls.
• Contractor to protect existing finishes in affected areas,if those finishes are to remain. Existing finishes to
be protected with plastic sheeting,cardboard or other padding.
• Laundry to remain until mutual agreed upon time
• Site Protection will be tended to throughout the project as needed
• Supply and Install Site Protection for the following areas:
• Entry Area and stairs to 2nd Floor
• 2nd Floor Hall to Master Bath and Kids bath
• Master Bedroom hardwood floors—Ramboard,taped joints
• Master Dressing room hardwood floors,as necessary—Ramboard.taped joints
Demolition
General Notes:
• Contractor to disconnect electrical,cable,phone and plumbing as required in affected areas prior to
demolition.
• Where Contractor is removing and saving an item,he will use his best efforts to remove that item with
minimal damage. Storing&protecting the saved items is the responsibility of the Owner. Re-installation
of the saved items is not included unless otherwise specified.
• Where Contractor is removing existing tile,assume the is laid on plywood or gypsum wall board. Removal
of cement board underlayment or a mud base would be extra.
• The abbreviations R/S=remove&save.RIDNS=remove and do not save.
• Contractor-to perforin demolition tin=ork per the following notes:
• Master Bath
o R/DNS all finishes and fixtures down to subfloor and framing
o Skylight&plaster in shaft to remain
n Insulation in walls&ceiling to remain
o Cut and strip siding for new windows
• Master Bedroom
o R/DNS Ceiling Plaster
o R/S Plywood sub floor from attic
o R/S Fiberglass batt insulation from Attic floor.
• Master Dressing Room
o None at this time
• Laundry Room
o R/S Washer and Dryer
o R/S HVAC grills
o R/DNS Floor Tile
o R/DNS Wire Shelving
o R/DNS Baseboard
o R/DNS light fixture
• Kids Bath
o R/DNS plumbing fixtures,light fixtures, mirror,accessories,vanity,baseboard,tile floor,
linen closet shelving,interior door hardware,plaster ceiling except linen closet,plaster
Page 2 of 16 Initiab?�idr
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around fiberglass shower,and plaster behind vanity as necessary to accommodate
plumbing revisions.
o Do not remove:plaster on walls,window trim,interior doors including jambs and trim,
and HVAC supply.
Excavation/Sitework
General Notes:
• None at this time
Concrete
General Notes:
• None at this time
Masonry
General Notes:
• None at this time
{
Floor Framing and Beam Work
General Notes&Specifications:
• All framing materials to be#2 KD SPF unless otherwise noted.
• Supply and install Floor Framing woi*in the following areas:
• Master Bedroom(ceiling/attic floor)
o Cut and raise ceiling joists in attic for tray ceiling including all supports(approx 13'x 14'
area)
o lx3 Dry Furring @ 16"OC-entire ceiling front to back in line with existing rafters.
Must strap from above—Strapping to counteract outward thrust of rafters.
o Frame Soffit with 2x6 stock-2'x 13'x 2 sides
o Re-install existing subfloor in Attic
Wall Framing
General Notes&Specifications:
• Framing lumber to be kiln-dried#2 SPF unless otherwise noted.
• Frame walls per plans and the following notes:
• Supply and install[Vall Fronting in the following areas:
• Master Bath
o (2)2x4 half walls at shower
o Cut and firame(2)new openings.for new window locations,per plaids.
o Cut abd frame(2)new openings for recesse"r!-medicine cabinets
o Blocking in walls for cabinetry or accessories
o Cut and frame for new pocket door,including pocket door track hardware
• Kids Bath
o Linen Closet to remain
o Blocking in walls for cabinetry and accessories
Roof Framing
Supply and install Roof Framing in the following areas:
• Master Bath
o Frame small soffit at shower entry for crown line
o Existing ceiling strapping to remain
• Master Dressing Room
o Frame small soffit at shower entry for crown line
• Master Bedroom
o See"Floor Framing"
• Laundry Room
o Existing ceiling to remain
• Kids Bath
Page 3 of 16 Initi �!�"
o Existing ceiling strapping to remain
o Frame small soffit at shower entry for crown line
• 2"d Floor Hall
o Frame opening between existing rafters in attic for new sun tubes in 2nd floor hall
o Frame opening between existing ceiling joists in attic for new sun tubes in 2nd floor hall
Roofing&Flashing
• 2"d Floor Hall/Roof
o Patch existing asphalt shingle roofing around 2 new suntubes on back roof,match
existing.
Gutters&Downspouts
General Notes&Specifications:
• None at this time
Exterior Trim
General Notes&Specifications:
• Window casings: 5/4"x4 PVC
• Window sills: 1-7/$"x 13/4"PVC
• Supply and install Exterior Trim in the following areas:
• (2)new window locations in Master Bath
Siding
General Notes&Specifications:
• Tyvek housewrap, taped seams
• 1i x6 WRC VG Finger Jointed Primed Cedar Clapboards
• Install at 4"exposure with rough side out,face-nailed with stainless steel nails
• Prime all end cuts in the field during installation.
• Inside corners butt to'/"x '/"PVC grounds.
• Outside corners butt to corner boards.
• Supply and install Siding in the following areas:
• Areas around(2)new window locations: Master Bath and Dressing room(Approx. 75 SF)
Exterior Windows
General Notes&Specifications:
• -Manufacturer: Anderson
• Series: 400 —
• 'Exterior: White Aluminum Clad
• interior Finish: Bare Pine
• Muntins:6/6 removable maple interior grilles
• Glazing: Low"E"II insulated glass with Argon gas.
• Exterior Casing:None
• Jambs: 5-9/16"
• Window Screens: Full Charcoal fiberglass mesh with white aluminum surround.
• Window Hardware: Estate polished chrome sash locks
• Supply and install fVindow.s in the following areas:
• (2)TW20310 windows in Master Bath
• (2)Suntube: Velux TGF 014 14"x96" Flexible Tube 2nd Floor Hall
Porch& Deck Finishes
General Notes&Specifications:
• None at this time
Page 4 of 16 Initi. s:
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Plumbing and Heating
General Notes&Specifications:
• Allotrnent Items: Plumbing Fixtures to be selected by Owner and supplied by Plumbing Subcontractor.
• Type L Copper Water pipe or Pex
• PVC Drains&Vents.
• PVC Plumbing vents through the roof.
• Supply and install Plumbing Work in the following areas:
• Master Bath
o Disconnect and cap for demo
o Install rough waste,vent and water piping for(2)sinks,toilet,shower and tub
o Supply and install copper pan and strainer. Install shower valve rough
o Set Tub and install valve
o Install finish plumbing
o Existing water pipe risers assumed to be adequate
• Laundry
o Existing washer hook-up to remain
o Install electronic safety valve
• Kids Bath
o Disconnect and cap for demo
o Prep waste and water for(2)sinks and toilet going back in same location
o Install rough waste;vent and water for shower
o Install Kohler cast iron shower base and rough shower valve
o Install finish plumbing
HVAC
• Supply and install HVAC Work in the.following areas:
• Master BedroomBath
o Relocation of(l)ceiling supply in bedroom and(1)wall supply in bath.
o All other rooms existing ductwork to remain.
Electrical
General Notes&Specifications:
• Allotment Item: Decorative Electrical Fixtures. Selected by Owner,supplied by Contractor.
• Fixtures supplied by Electrical Subcontractor: recessed lights with standard white trim and baffles,rope
lights and bathroom exhaust fans. 4
• Outlets and switch plates to match existing
•. Dimmers switches to be toggle style
• Supply and install Electrical Yho►k in the following areas:
• Master Bath
o P/I--(1)Remote exhaust fan with 2 lit intakes w/two switches(timer for fan,dimmer for
lights),vented to exterior
o Install decorative fixtures at vanity: (2)single wall sconces,(1)double wall sconce,with
dimmer switches.
o Install decorative fixtures at tub: (2)single wall sconces with dimmer switch.
o Install(2)GFI vanity outlets
o Wire for(2)electrified Medicine cabs
• Master Bedroom
o Allotment Item: Install(1)ceiling fan with remote control
o P/I 48' rope light round new tray ceiling with switch
o P/I(4)4"LED cans with dimmer
• Kids Bath
o P/I(1)Panasonic exhaust fanlight w/2 switches—vented to exterior
o P/I(1)4"LED can with switch for shower
o Install(3)vanity lights
o Install(2)20 Amp GFI outlets for vanity
Page 5 of 16 Initia • _ _ ��
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• Laundry Room
o Replace existing ceiling fixture in same location,using existing switch
• 2nd Floor
o No smoke detector work included.
Insulation
Supply and install Insulation Work in the following areas:
• Master Bath/Laundry/Kids Bath
o Exterior Walls-Replace as needed.
• Master Bath
o Insulate behind(2)medicine cabinets in exterior wall with 2" isocyanurate foil-faced
foam board
• Master Bedroom
o Replace existing ceiling/attic insulation as needed after framing tray ceiling
• 2nd Floor Hall/Attic Roof
o Patch existing spray foam in roof at Suntube penetrations
Plaster
General Notes&Specifications:
• Walls: %"gypsum blueboard screwed to studs:smooth skim-coat plaster finish. f
• Ceilings: ''/z"gypsum blueboard screwed to strapping smooth skim-coat plaster finish
• Supply and install Plaster Pflork in the following areas:
• Master Bath
o Walls and Ceiling per plans-Approx.300 SF wall, 115 SF Ceiling '
o Skim coat skylight shaft to smooth finish
• Master Bedroom
o Ceiling-Approx.320 SF(includes Ribbon and Tray,no new wall paster)
• Master Dressing Room
o New Crown Soffit
• Laundry Room
o Existing to remain
• Kids Bath
o Walls-Approx. 80 SF along vanity wall(exterior wall and linen closet plaster to remain)
o Ceiling-Approx.65 SF
• 2nd Floor Hall
o Patch around Suntube penetrations
Tile
.-.
General Notes&Specifications:
• Allotment Item: Tile and grout materials to be selected by Owner and supplied by Contractor.
• Supply and install t/2"cement board underlayment over new or existing plywood subfloors to receive tile.
Cement Boards to be set in thin set and nailed with galvanized nails to die sub floor
• NOTE: Existing plywood must be YV thick with T&G edges. If not,additional underlayment will be
required at extra cost.
• Supply and install 1/2"Durock screwed to stud walls and strapped ceiling in shower.
• Tile to be set with"thin set"over Durock.
• Apply waterproofing over Durock in showers.
• Supply and install Tile Work in the following areas:
• Master Bath
o Allotment Iters: Main Floor,set square(non diagonally)approx. 85 SF
o Allotment Item:Shower Floor,set square(non diagonally)approx. 16 SF
o Allotment Item: Shower Wails and Ceiling,set square(non diagonally)approx. 52 SF
o Allotment Item:Shower Insert and Frame set diagonally approx 34 SF
0 2 Niches and custom stone door threshold to match vanity top
Page 6 of 16 ]niti o Sp
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o Allotment Item: Fabricated Stone Shower Set including bench,shelves, threshold,jambs ,
and wall cap
+ Kids Bath
o Allotment Item: Main Floor,set diagonally approx.40 SF
o Allotment Item: Shower Walls and Ceiling,set square(non diagonally)approx.94 SF
o Allotment Item: Shower Insert and Frame
o I Niches and custom stone door threshold to match vanity top
o Allotment Item:Fabricated Stone Shower Set including shower sill to match.2 niches.
Shower seat
• Laundry Room
o Allotment Item: Main Floor,set diagonally approx.46 SF
o Custom stone threshold
Interior Doors
General Notes&Specifications:
f
• Allotinent Rena: Interior Door Hardware and Hinges;Owner to confirm style,finish and privacy/passage
options prior to ordering.
• Supply and install Interior Doors in the following areas:
• Master Bath
o (1) 15 light,wood, french pocket door slab with frosted glass
• Master Bedroom
s
o Adjust existing pocket doors
• Laundry/Kids Bath
o Existing doors to remain
• 2nd Floor
o Replace existing door hardware and hinges in 10 locations. Owner to select radiused
hinge plates.
Interior Trim&Millwork
General Notes&Specifications:
• Window Casing: 3 pes,3 1/2"Jalco mitered paint grade FJP(Finger Jointed Pine)
• Stool Cap: #1276, 11/16 x 4"Clear Pine
• Apron:#8063 '/a"Quarter Round Clear Pine
• Door Casing: 3 pcs,3 1/2"Jalco mitered paint grade FJP(Finger Jointed Pine)
• Baseboards: 1 x 6 paint grade FJP with 1 3/8 scotia cap#8455
• Room Crown: #8009 9/16 x 3 5/8,FJP
+ Med Cab Crown:#6 ID Solid Crown,FJP
• Chair Rail:#8630 1.1/16x-2 5%8"-Clear Pine
• Panel Mouldings:#8463 11/16x 1 '/2 Band,Clear Pine
• Supply and install Interior Trim &Millwork in the following areas:
• Master Bath
o (2)Window Casings/Stool Cap and Apron
o (1)Door Casing
a (1)Set of pocket doorjambs
o Baseboard and Cap
o Chair Rail
o Applied Panel molding on walls,per elevations
o Crown
a Medicine Cabinet crown surround
• Master Bedroom
o (1)Door Casing
o Crown around perimeter of room
o Crown around perimeter of`fray ceiling
• Master Dressing Room
o Crown around perimeter of room,N.i.0 alcove
Page 7 of 16 [ni
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• Laundry Room
o Baseboard and Cap
• Kids Bath
o Baseboard and Cap
o Crown
o Mirror crown and surround
o New Shelves in existing linen closet:(5)fixed shelves.,3l4" thick,hardwood plywood
with solid wood edges-,painted
Cabinets
General Notes&Specifications:
• Cabinet Allotments include cabinets,moldings,and finishing.
• Supply and install Cabinets in the following ureas:
• Master Bath
o Allotment Item: Master Bath Vanity 66"
• Kids Bath
o Allotment Item: Bath Vanity 60"
• Laundry Room
o Allotment Item: HCBG site built shelves and hanging rod.
Countertops
General Notes&Specifications:
• Countertop Allotments include all materials and installation labor including materials and labor for
templating.
• Supply and install Countertops in the following areas:
• Master Bath
o Allotment Item: 3cm white rhino,honed,Ogee edge,4"Back Splash and#2 U/M C/O
• Kids Bath
o Allotment Item: 60"Stone top with 4"backsplash
Appliances
• Install Owner supplied washer and dryer in existing locations using existing washer hook-up and
existing dryer venting.
Specialties
• Supply and install Specialties in the following areas:
Master Bath
o Allotment Item -(2)Recessed,electrified medicine cabinets
o Allotment Item-Glass Shower door and surround. 318 glass,hardware,material and
installation
o Allotnaent Item -Master Bath Accessory Set
• Kids Bath
o Allotment Item-Glass Shower door and surround. 3/8 glass,hardware,material and
installation
o Custom Mirror-approx 42"x60"x 1/8",polished edges,and cut-outs for lights
o Allotment Item:Bath Accessory Set
Floor Coverings
General Notes:
• None at this time
Painting
General Notes&Specifications:
• Owner to select colors,Contractor to supply materials and labor.
• All paints to be Benjamin Moore,Latex unless otherwise specified below
Page of 1
g Ci ?V
• Colors&Sheens:
o Ceilings: flat. white:other colors or sheens would be extra.
a Walls: flat or eggshell; (1)color per room,dark colors may require additional coats to cover,
which would be extra:
o Trim Doors&Windows:satin or semigloss;(1)color per room different than walls;dark colors
or dramatic contrast to wall color may be extra.
o Exterior Trim: satin or semigloss;(1)color different than siding_dark colors or dramatic contrast
to siding color may be extra
o Siding: flat or eggshell.(1)color different than the trim;some colors may require additional coats
to cover, which would be extra.
• Unless otherwise noted below,interior painting of existing rooms if included,shall generally include,prep
plus(1)finish coat of paint on ceilings,walls,trim,windows and doors.
• Supply and install Painting in the following areas:
• Master Bath
o Walls and Ceilings
o All trim and doors
• Master Bedroom ¢
o Walls and Ceilings and trim
• Master Dressing Room
o Crown and Walls
• Laundry Room '
o Walls and Ceiling
• 2"d Floor Hall
o Walls and Ceiling
Clean-up
General Clean-up notes:
• Jobsite to be cleaned up daily.
• All construction debris to be removed from site.
• At completion of the Work,the Contractor shall remove construction equipment,tools,and machinery and
surplus materials from site.
• The house shall be left"broom clean"upon completion.
• Contractor to provide on-site dumpsters during demolition and construction. Owner and Contractor to
agree on exact location.
• Final cleaning by owner
C. CONTRACT DOCUMEN'T'S
"The"Contruet Documents"consist of this Agreement, the Attachments listed-above(if any),and__ - - _ -
Modifications issued and signed by the parties after execution of the Contract. There are three(3)types of
modifications: Field Change Order,Contract Change Order,and a written amendment to the Contract signed by
both parties.
D. <omitted>
E. CONTRACT SUM (lump sum for all Work described above): $ 157,841
F. TOTAL ALLOTMENTS included in Contract Sum): $ 49,646
(see attached List of Allotments)
r� 7
G. <OMIT> �� � !
H. CONTRACT TIME
Contractor to Commence Work on or about October 7,2013. Contractor to achieve Substantial Completion of
all Work in this Agreement on or about December 20,2013 not including delays and adjustments for delays
caused by:additional time required for performance of Change Order Work(as specified in each Change
Page 9 of 16 lnitia \ S�
i
Order),delays caused by failure of Owner to perform their responsibilities under this Agreement,inclement
weather,accidents,and other delays unavoidable or beyond the control of Contractor. '
{
111.GENERAL CONDITIONS FOR THE AGREEMENT ABOVE
A. <omitted>
B. <omitted>
C. EXCLUSIONS
Unless specifically:included in the Scope of Work described above,this Agreement does not include labor or
materials for the following Work:
1. Fees for Design and Engineering("D&E")Work including any additional D&E Work required by building
inspectors. If a separate Pre-Construction or Design Services Agreement is in place between Owner and
Contractor,all D&E Work shall be paid for by Owner according to the terms of such Agreement
2. Surveying that may be required to establish accurate property boundaries for setback purposes
3. Temporary sanitatien;power,or fencing
r
4. Moving Owner's property around the site
5. Repair or replacement of Owner-supplied materials
6. Public or private utility connection fees
7. Repair of unforeseen and concealed conditions including,but not limited to,repair of concealed
underground utilities not located on prints or physically staked out by Owner which are damaged during
construction
8. Testing,removal and disposal of any materials containing asbestos(or any other hazardous material as
defined by the EPA)
0. Ren;AAI,al of filled b
r-eund OF FE)ek Of ally etheF materials not removable by ordinary hand ioels or-etherit ah-eady on site
10. Any b
11I. De Wafffiflg eferwavatiom
.13. Geld weather-additiNvs(E)e8liffete eF insulatien of eeamte fefffls if required due to eald weathei,
eenditieps
14. Correction of existing out-of-plumb or out-of-level conditions in existing structure
15. Correction of concealed substandard framing.
16. Removal and replacement of existing rot or insect infestation
1.7. Re-routing/removal of vents,pipes,ducts,wiring,conduits,structural members,or steel mesh which may
- - be discovered-in-the-removal=or cutting of openi igs.in the existing-structure:- --
18. Failure of surrounding part of existing structure,despite Contractor's good faith efforts to minimize damage
such as plaster or drywall cracking and popped nails in adjacent rooms.
19. Repair of damage to existing roadways,driveways,sidewalks,or grass areas that could occur when
construction equipment and vehicles are being used in the normal course of construction
20. Exact matching of existing finishes. Where Contractor's Work involves the"matching of existing finishes
or materials," Contractor will use his best efforts to match existing finishes and materials.However,an
exact match is not guaranteed due to such factors as discoloration due to the aging process,difference in
dye lots,and difficulty of exactly matching certain finishes,colors,and planes.
21. Final construction cleaning(Contractor will leave site in"broom swept"condition)
22. Landscaping and irrigation work of any kind.
23. Any item on the Plans marked"Not in the Contract"or"NIC".
D. CONTRACT SUM
The Contract Sum is stated in the Agreement and,including adjustments authorized through Change Orders,or
amendments to this Agreement,is the total amount payable by Owner to Contractor for performance of the
Work under the Contract Documents.
Page 10 of 16 Initi f�
E. PROGRESS PAYMENTS AND COMPLETION
1. APPLICATIONS FOR PAYMENT: Based upon Applications for Payment(Invoices)submitted to
Owner by Contractor,Omer shall make progress payments on account of the Contract Sum to Contractor
as provided in the Contract Documents. Applications for Payment(Invoices)shall be prepared by
Contractor approximately every two(2)weeks and submitted to Owner. Payment is due within five(5)
business days after receipt of the Application for Payment by Owner.
2. CALCULATION OF PAYMENT AMOUNT: Applications for Payment(Invoices)shall itemize the
amounts due thru the Invoice Date for completion or partial completion of the Work and/or project
milestones as shown on the Schedule of Values below and any Change Order Work added to the Schedule
of Values. The Schedule of Values,which allocates the Contract Sum to the various portions of the Work
and project milestones,shall be used as a basis for Contractor's Applications for Payment,but shall not be
used as a basis for the value of Woi*added to or deleted from the Agreement.
SCHEDULE OF VALUES:
1 Initial Deposit due when Agreement is signed and returned to Contractor $ 20,000
2 Site Prep and Demolition $ 7,000
3 Framing $ 4,000
4 Exterior Roofing,Siding,Window and Trim $ 4,000
5 Plumbing Fixtures S 18,500
6 Plumbin $ 17,000
7 FIVAC $ 300
8 Electrical $ 8,000
9 Insulation $ 1,000
10 Plaster S 3,000
11 Tile and Stone Materials $ 12,000
12 Tile and Stone Installation S 7,000
13 Interior Trim and Doors $ 11,500
14 Cabinets $ 7,500
15 Cabinet installation $ 3,000
16 Specialties $ 10,000
17 Painting $ 6,000
18 Permit $ 2.000
19 Supervision and Management $ 11,041
20 Substantial Completion of Phase#1:Master bedroom,master bath and laundry $ 2,500
21Final_Payment:__Balance of contract_sutra due upon Substantial Eompletion of $ 2,500 -
Phase#2: master dressing room,kids bath and 2nd floor hall
3. FAILURE OF PAYMENT: If Owner docs not pay Contractor within the time indicated above,then
Contractor may stop the Work until payment of the amount owing has been received. The Contract Time
shall be extended appropriately and the Contract Sum shall be increased by the amount of Contractor's
reasonable costs of shutdown,delay and start-up,plus interest as provided for in the Contract Documents.
4. INTEREST ON OVERDUE PAYMENTS AND ATTORNEY'S FEES: Payments due and unpaid
under the Contract Documents shall bear interest from the date payment is due at the rate of one and one
half percent(1-1/2%)per month. Owner shall be responsible for reasonable attorney's fees incurred by
Contractor in collecting any sums due hereunder.
F. <omitted>
G. <omitted>
H. <omitted>
I. <omitted>
Page 1 I of 16 Inti
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J. OWNER'S SEPARATE SUBCONTRACTORS
Owner shall not hire separate Subcontractors to work on the site at same time as Contractor without prior
written consent from Contractor. Contractor reserves the right to not allow uninsured,unlicensed or unqualified
subcontractors to work on the site at the same time as Contractor-. Owner may hire separate Subcontractors to
work on the site either before Contractor's date of Work Commencement or after final completion of the Work.
K. CHANGE ORDERS
1. FIELD CHANGE ORDER(hereinafter referred to as"FCO")is a written or verbal directive from Owner
for Contractor to proceed with a change in the Work prior to the final cost of the change being known,the
exact amount of extra time required for performance of the change,and prior to a"Contract Change Order"
being executed. Owner may issue a verbal FCO to Contractor for a change in the Work,and may direct
Contractor to commence with the change prior to signing a written FCO or CCO. In this case,Contractor
shall commence with the change in the Work and Owner shall be obligated to pay for additional costs
incurred as a result of the change in the Work. Contractor shall follow-up with a written FCO or CCO to
be signed by Contractor and Owner,as soon as is reasonably possible.
2. CONTRACT CHANGE ORDER(hereinafter referred to as"CCO")is a written signed agreement
between the parties to change the Work including the cost of the change,and the change to the Date of
Substantial Completion specified in this Agreement. The cost of the Change Order is then incorporated
into the Schedule of Values and becomes payable according to the payment terms of this Agreement.
3. CONCEALED CONDITIONS: If conditions are encountered at the site which are(1)unforeseen,
subsurface or otherwise concealed,and which differ from those indicated in die Contract Documents or(2)
unknown conditions which differ from those ordinarily found to exist and generally recognized as inherent
in construction activities of die character provided for in the Contract Documents,then a CCO shall be
written to equitably adjust the Contract Sum and Date of Substantial.Completion due to the Change in the
Work as determined by Contractor.
4. CHANGES IN THE WORK: Any change from the Scope of Work referred to in the Contract
Documents involving extra costs of materials or labor will be performed upon a written or verbal FCO or a
written CCO issued by Contractor and signed by Contractor and Owner prior to the commencement of
Additional Work by Contractor. Contractor's profit and overhead,and any supervisory labor will not be
credited back to Owner with any deductive Change Orders(Work deleted from Agreement by Owner).
L. PAYMENTS AND COMPLETION
1. <omitted>
2. DEFINITION OF SUBSTANTIAL COMPLETION: Substantial Completion is the stage in the
progress of the Work when the Building[Work or Improvement or designated portion thereof is sufficiently
complete in accordance with the Contract Documents so that Owner can occupy or utilize the
Building/Work-of Iinprovenientfor its intende8:use.-
3. PUNCH LIST WALK-THRU: When Contractor considers the Work.or portion thereof,which Owner
agrees to accept separately,is substantially complete,Contractor and Owner shall perform the Punch List
Walk-thru and agree on the list of Work remaining for Contractor to achieve"Final Completion"of the
Work. This list of Work shall be referred to as"The Final Punch List". Contractor and Owner will then
place a fair and reasonable value on each item on the Final Punch List.
4. <omitted>
5. FINAL PAYMENT AND HOLDBACK FOR PUNCH LIST WORK: The final contract payment is
due and payable upon Substantial Completion(not'Finai Completion)of the Work under contract. At the
time of making the final contract payment,Owner may hold back the value of the Punch List Work times
two,or$1000,whichever is greater. This hold back for Punch List Work assures Owner that Contractor
will complete all Punch List Work in a timely manner.
6. FINAL COMPLETION AND PAYNIENT OF HOLDBACK: Upon completion of the Punch List
Work,Owner shall pay the hold back amount and any other amounts due and payable to Contractor under
the Contract Documents.
7. <omitted>
8. PAYMENTS/CREDITS FOR ALLOTMENT OVERAGES/UNDERAGES: The cost of items
designated in the Agreement as Allotments have been initially factored into the Contract Sum and Schedule
of Values. If the actual cost of an item exceeds the Allotment amount,the difference between the actual
Page 12 of 16 lnitiauo�)m�/*_
cost including taxes and delivery charges and the Allotment amount will be added to the Contract Sum via
Change Order. Contractor overhead and profit will not be added to material only Allotment overages as
long as the scope of work to receive,handle, install,and warrant such materials has not increased. For
Allotment items that include materials and installation labor,overhead and profit will be added to the labor
portion of an Allotment overage. If the actual cost of an item is less than the Allotment amount,a credit
will be issued to Owner after all billings related to this particular Allotment have been received by
Contractor.This credit will be issued via Change Order prior to calculating the final payment owing under
the Agreement.The amount of the credit will be the difference between the Allotment and die actual cost of
die item including taxes and delivery charges. Contractor overhead and profit will not be credited back to
Owner on Allotment underages.
9. <omitted>
M. INSURANCES
1. CONTRACTOR'S INSURANCE: Contractor shall carry the insurances listed below throughout the
course of the project,and file certificates of such insurance with Owner prior to commencement of Work:
a. General Liability Insurance
b. Massachusetts Worker's Compensation Insurance for its employees
2. OWNER'S INSURANCE: Owner shall purchase and maintain replacement cost property insurance on all
property existing at the Project Address throughout the course of the project,and file a certificate of such
insurance with Contractor prior to the Date of Work Commencement as follows:
a. Owner's Insurance shall be written on an,"All Risk"or"Special"coverage basis including earthquake
and flood.
b. Owner's Insurance shall include replacement cost coverage of all completed Work of this project to the
full insurable value thereof,and remain in effect whether or not Owner occupies the premises during
construction.
c. Owner shall supply Contractor an insurance binder reflecting Owner's insurance carrier is aware of
project by listing project in remarks section of binder.
d. Owner's Insurance shall contain a provision that the policy will not be canceled or allowed to expire
until at least 30 days' written notice has been given to Contractor.
e. Owner shall name Contractor as a Loss Payee on Owner's Insurance until all sums due under this
Agreement have been paid by Owner to Contractor.
f. Owner agrees,to the extent permitted by law,to hold harmless,indemnify and defend Contractor from
any and all loss arising out of this project.
N. WARRANTY
1. Upon final payment by Owner of the entire contract sum including all change orders and allotment
overages(if any)due to Contractor,_Contractor warrants to Owner that the.Work performed.under the
Agreement is free from defects,not inherent in the quality used,in materials,equipment and workmanship
for a period of two(2)years after the date of substantial completion as described in die Agreement.
2. THIS LIMITED WARRANTY CONTAINS ALL EXPRESS WARRANTIES OF
CONTRACTOR, ALL OTHER WARRANTIES EXPRESS OR IMPLIED ARE
EXCLUDED AND HEREBY DISCLAIMED, INCLUDING WITHOUT LIMITATION,
ALL WARRANTIES OF MERCHANTABILITY, HABITABILITY AND FITNESS FOR
A PARTICULAR PURPOSE. Except for any warranties implied by law and not subject to exclusion,
there are no warranties that extend beyond the express warranties set forth herein. The term of any
warranties implied by law and not subject to exclusion shall end upon the termination of this Limited
Warranty. In die event of breach by Contractor,Owner's recovery shall be limited to the actual cost to
repair any defect or deficiency covered by this Limited Warranty. Owner waives any and all claims for
incidental,consequential,special and consumer protection damages. The parties agree that Massachusetts
law shalt control this Limited Warranty and jurisdiction is proper in the Massachusetts Superior Court.
3. Owner shall notify Contractor in writing,within thirty(30)days after the discovery of any failure,defect or
damage: otherwise die claim shall be deemed waived. In the event of an emergency failure(i.e. roof or
plumbing leak),Owner should contact Contractor immediately by telephone at the number listed above. If
Owner gives Contractor proper notification and if the condition is covered by this Limited Warranty,
Page 13 of 16 Init' _ /591
Contractor or subcontractors chosen by Contractor will replace or repair die defect(the decision to repair or
replace is Contractor's sole decision)at no charge or cost to Owner within a reasonable time,not to exceed
sixty(60)days,unless weather conditions,labor problems or shortages causes delays. Any steps taken by
Contractor to correct defects under this Limited Warranty shall not extend the time of this Limited
Warranty.
4. Owner acknowledges that die following,as applicable,are EXCLUDED from this Limited Warranty:
a. Defects which are dte result of characteristics common to materials used,such as,but not limited to,
warping or deflection of wood;fading,chalking and/or checking of paint due to sunlight;cracks in
concrete,plaster,brick masonry,Y,b routs and caulking due to drying and/or curing.
b. Hairline cracks and seams in plaster and drywall other than those caused by structural defects,
provided that joints are properly located to minimize cracking. Any repair of plaster or wallboard,
caused by structural defects,may not completely blend with surrounding materials.
c. Shrinkage,swelling,or leakage of doors and windows attributable to weather conditions.
d. Occasional dents of interior woodwork and twisting,and hairline checking of wood framing,plywood,
exterior siding and wood trim.
e. Shrinkage or separation of hardwood flooring.
f. Damage to roofs caused by snow or ice backing up under shingles or damage,if any,caused by
windblown rain or snow through roof,gable or soffit vents,or louvers into attic space,unless caused
by negligent workmanship or defective material. It is Owner's obligation to insure free passage in
gutters and downspouts at all times.
g. Fading or darkening of paints,stains and other finishes exposed to sunlight.
h. Defects in items supplied or installed by Owner,or anyone other than Contractor or its subcontractors
acting at Contractor's order.
i. Defects in materials or equipment that are covered by manufacturer's warranties including labor to
repair same,even if such tabor cost is not warranted by manufacturer. Contractor,at Owner's written
request and at no expense to Owner,shall act as Owner's agent in pursuing the manufacturer for any
defects in materials supplied and installed by Contractor.
j. Damage due to abuse,improper or insufficient maintenance,improper operation,alteration,
modification or normal wear and tear under normal usage.
k. Contractor assumes no liability for damages to personal property of Owner.
1. Loss or damage which Owner has not taken timely action to minimize.
m. The presence or development of radon and mold are products of environmental conditions that are
beyond the control of Contractor,therefore Contractor does not warrant and expressly disclaims any
responsibility for the presence or development of radon or mold.
O. WORK STOPPAGE,TERMINATION OF CONTRACT BY CONTRACTOR
1.. C:ontractor_.shall.have.the_right_to_stop all Work.on the.project.and keep,the job..idle if;_
a. payments are not made to Contractor in accordance with the Payment Terris in this Agreement,or if
b. Owner repeatedly fails or refuses to furnish Contractor with access to the job site and/or product
selections or information necessary for the advancement of Contractor's Work.
2. Simultaneous with stopping Work on the project,Contractor must give Owner written notice of the nature
of Owners default and must also give Owner a fourteen(14)day period in which to cure this default.
3. If Work is stopped due to any of the above reasons(or for any other material breach of contract by Owner)
for a period of fourteen(14)days,and Owner has failed to take significant steps to cure his default,then
Contractor may, without prejudicing any other remedies Contractor may have,give written notice of
termination of the Agreement to Owner and demand payment for all completed Work and materials ordered
through die date of Work Stoppage,and any other loss sustained by Contractor,including Contractor's
overhead and profit at the rate of eighteen percent(18%)on the balance of the incomplete Work under the
Agreement. '
4. Payment for this final invoice is due within seven(7)days of submittal of invoice by Contractor.
Thereafter,Contractor is relieved from all other contractual duties,including all Punch List and warranty
work.
5. If the contract is terminated and Owner pays all outstanding balances owed to Contractor,then materials
ordered through the date of Work Stoppage become the property of Owner.
Page 14 of 16 Intl"`� W
P. TERMINATION OF CONTRACT BY OWNER
1. Owner shall have the right to initiate termination this Agreement if:
a. Project remains idle for longer than fourteen(14)consecutive days after the Work has been started
without reasonable written notification of the cause of the Work Stoppage by Contractor to Owner,or
if
b. Contractor repeatedly fails to perform the Work according to the Contract Documents.
2. Owner must give Contractor written notice of the nature of Contractor's default and must also give
Contractor a fourteen(14)day period in which to cure this default.
3. if Contractor fails to take significant steps to cure his default within the fourteen(14)day period,Owner
may give written.notice to Contractor of Owner's desire to terminate this Agreement.
4. Upon receipt of Owner's written notice of desire to terminate this Agreement,Contractor has fourteen(14)
days to respond with an invoice for payment for all Work completed and materials ordered through the date
of Work Stoppage. Payment for this final invoice is due within 7 days of submittal of invoice by
Contractor.
S. After payment of final invoice Owner may terminate this Agreement and Contractor is relieved from all
other contractual duties,including all Punch List and Warranty Work.
6. If the contract is terminated and Owner pays all outstanding balances owed to Contractor,then materials
ordered through the date of Work Stoppage become the property of Owner.
7. Contractor shall not be responsible for any incidental or consequential damages incurred by Owner as a
result of such termination.
Q. DISPUTE RESOLUTION
1. The parties agree that Massachusetts law shall control this Agreement and jurisdiction is proper in the
Massachusetts Superior Court.
2. Any controversy or claim arising out of or related to this Agreement involving an amount of less than the
maximum limit of the small claims court must be heard in the Small Claims Division of the district where
Contractor's office is located.
3. Any controversy or claim arising out of or related to this Agreement which is over the dollar limit of the
Small Claims Court shall be settled by binding arbitration administered by JAMS in Boston,MA in
accordance with the Construction Industry Arbitration Rules.
4. The parties agree that mediation administered by JAMS in Boston,in accordance with the Construction.
Industry Arbitration Rules shall be a condition precedent to arbitration..
5. Judgment upon the award may be entered in any Court having jurisdiction thereof.
R. ENTIRE AGREEMENT,SEVERABILITY,AND MODIFICATION
This Agreement represents the full and complete understanding of every kind or nature between the parties with
respect to the services set.forth in_this:Agreement,_and_all_preliminarynegotiations and prior representations,
proposals and contracts,of whatever kind or nature,are merged herein and superseded hereby. No verbal
agreement or implied covenant shall be held to vary the provisions of this Agreement. Any modification of this
Agreement will be effective only upon written execution signed by both Owner and Contractor. In the event_
that any provision of this Agreement is at any time held by a Court to be invalid or unenforceable,the parties
agree that all other provisions of this Agreement will remain in full force and effect.
S. <omitted>
T. <omitted>
U. OWNER'S 3-DAY RIGHT OF RECISION
Owner may cancel this Agreement with no further obligations by notifying Contractor in writing that they wish
to cancel the Agreement within three(3)business days of the date they signed this Agreement.
Page 15 of 16 Initi� �/ 5.y�t
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I .have read and understood,and I agree to.all the tenns and conditions contained in die Agreement above.
01-3
at, Stephen D.Howell,President
Howell Custom Building Group,Inc.
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at
ate O n
Page 16 of 16 Initials:-/-/—
F
The Commonwealth of Massachusetts 17Pnnt orm- ____j
,. Department of Industrial Accidents
Office of Investigations
I Congress Street, Suite 100
Boston, MA 02114-2017
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Boc� .J2U
Address: 3(90 U�Qlr mac,cIL S-\ . 2>41 S S-k� 4A)
City/State/Zip:(&,,afv-Ac-Q- 6M A 01 Oo�-f 3 Phone #: q7 8 - Gg'i - q c/ YO
Are ou an employer? Check the appropriate box: Type of project(required):
1.[ 1 am a employer with 2c) _ 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. E] New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [,]Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp, insurance.+ 9. EJ Building addition
required.] 5. ❑ We are a corporation and its 10.[J Electrical repairs or additions
officers have exercised their 1 1. Plumbing 3.❑ I am a homeowner doing all work S repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
+Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: &-_�r-A
Policy#or Self-ins. Lic. #: i4 C)i-?C3 a k I./-(p Expiration Date: &
Job Site Address: 76L S uLO—C0c^f_ O-N-C City/State/Zip A).AJo._,,e_F ', d4A- G y j
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains andpenalties ofperjury that the in ormation provided above is true and correct.
Signature: _ ! _`01/x: ��� Date:19_/'.
l
Phone#: al 7K -,3&9 -91 Y yo
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#:
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t St.E rtSr CS-068232
STEPHEN 1D 1116;�ELL
15 MT VERNON RO t
BQD%1•OR D MA 0192.1.
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02/141,7014
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Office of Consumer Affairs and Business regulation
10 Parr Plaza - Suite 5170
Boston, Massachusetts 02116
Dome Improvement Contractor registration
—V= Registration: 175166
Type: Corporation
Expiration: 4/29/2015 Tr# 239150
HOWELL CUSTOM BUILDING GROUP
STEPHEN HOWELL
360 MERRIMACK ST
LAWRENCE, MA 01843
Update Address and return card.Mark reason for change.
`--' Address Renewal Employment U Lost Card
SCA 1 e: 20M-05/11 �/� /
O��%(/(,q/�CLCi2f!/re -
\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
F3,OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
registration 175,166 Type: Offece of Consumer Affairs and Business Regulation
ixpiration: -4/29f20t5 Corporation 10 Park Plaza-Suite 5170
Boston,MA 02116
HOWELL CUSTOM BUILDING€GROUP
STEPHEN HOWELL
15 MT VERNON RD
BOXFORD,MA 01921 - Undersecretary Not va i h without signature
