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Home My WebLink AboutBuilding Permit #778 - 789 TURNPIKE STREET 6/2/2010Permit NO: Date Issued: (t" 4,- BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic:'Well, Floodplain Wetlands Watershed District W aterlSewer DESCRIPTION OF WORK TO BE PREFORMED: ARCHITECT/ENGINEER 04;�- Phone: 9O 3 k o CP �l 111 Address: 3 �mtL-j2 (-� S-klem -til 0 ()"3 (57 � Reg. No. 14"t 1 C FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ Sia ) c Y FEE: $ Check No.: Receipt No.: Z v NOTE: Persons contracting with unregistered contractors do not have access 0,RQ guava fund Signature'of Agent/Owner Signature of contracto Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools i)"' 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 APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/signature & Date Driveway Permit DPW Town Engineer: Signature: Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NOTES and DATA — (For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 No 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 o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products . NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ 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: Building Permit Revised 2008 Location �U.G 4 01 k9e No. 7 Date – c) NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ -ILIL-^ 1 Foundation Permit Fee $ s — Other Permit Fee $ TOTAL $ Check #� r, Y:Z�� 2 5 L Building Inspector THE COMMONWEALTH OF MASSACHUSETTS STATE BUILDING CODE CONSTRUCTION CONTROL AFFIDAVIT On this 26th day of May. 2010 A.D. before me, for the appeared Richard E. Landry who, being duly sworn, deposed and Architecture in the Commonwealth of Massachusetts and that he design plans and construction documents for the Renovations to State of New Hampshire, personally says that he is registered to practice has supervised the preparation of all applicable provisions of the Massachusetts State Building Code 7 edition), the National Fire Protection Association and that the materials specified for use in the construction conform with the Controlled Construction Procedure therein defined (Section 116); and that a professionally qualified representative of his office will administer the Construction Contract, and that he will make regular and periodic visits to the construction site and prepare written progress reports of said visits to be sent to the permit granting authority to determine that the construction is proceeding in accordance with the approved plans, and that he will inform the Owner and the permit granting authority of any observed deviations from the approved plans or applicable codes. (Si! ,'ERED ARS �7�cvG�P�) ERNEST�9�TFc� No. 4496 Q WINDHAM, a N.H. J� V� �LrN OF MASS SUBSCRIBED AND SWORN TO BEFORE ME THIS 26th DAY OF May, 2010 A.D. My Commission ExpiresZ3 l (Notary P4 Wr mm 'NIassachu etts - Departnient of Public Safet% Board of Building; Regulations antl Standards Construction Supervisor License License: CS 96729 Restricted to: 00 a PAUL PURPORA e P.O. BOX 397 BARRINGTON, NH 03825 • .. •' u-�'m-,nh in .n •.wwi^rah. • I Expiration: 3/8/2012 C'ommissioncr Tr#: 23023 i Restricted to: 00 00 - Unrestricted 1G -1 2 Family Homes Failure to .possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: `tivvvW.Mass.Gov/DPS mcci Mark carrier Construction, Inc. 175 Lincoln Street, Suite 101 Manchester, NH 05105-5051 Phone 603-627-9506 Facsimile 603-647-2270 May 13, 2010 John O'Horo, DMD, PC 565 Turnpike Street, Suite 63 North Andover, MA 01845 Re: 3,652 sf Dental Office Fit -Up 789-793 Turnpike Street, North Andover, MA REVISED Dear Dr. O'Horo, Mark Carrier Construction, Inc. respectfully submits the following REVISED proposal for your dental office fit -up at 789-793 Turnpike Street in North Andover, MA. Our scope of work is based upon plans by Henry Schien Dental, dated 11/26/08 and interior finishes by The Inside View, finish schedule and interior designs dated 3/16/10. Following is the proposed scope of work and budget pricing: Architectural: Code review and required stamping of plans will be handled as an allowance. The intent i� to utilize plans as developed by Henry Schien and The Inside View. The Architect will do overall code review and make necessary adjustments to achieve code compliance. This will require a site visit and a partial redraw of plans on his stamped sheets for permit. This work is included in our Architectural allowance of $8,500. The mechanical, electrical and plumbing plans will be drawn by the contractors as design build and if required the allowance for reviewing and stamping their work is in the engineering allowance. We are carrying an engineering allowance of $9,000. Site -work: • None required. Concrete: Saw cut and remove existing 4" thick concrete slab as needed for plumbing and electrical installations. Repair slab on grade, 4" thick, 3,000psi concrete with fiber -mesh reinforcing with vapor barrier. Slab patches will be doweled in existing concrete three foot on center staggered, with %" x 12" dowels. • Concrete pads formed and poured as required by HVAC equipment. John O'Horo, DMD, PC May 13, 2010 Page 2 Wood and Plastics: Wood blocking for electric panels, dental equipment (See Sullivan -Schein plans) and back-up for bathroom accessories is to be installed within the drywall/steel stud partitions. Interior casework, counters, cabinets and shelving outside of that being provided by the dental equipment supplier and drawn by The Inside View are part of the base contract. Casework in the Operatory and Hygiene rooms is not included under this contract and can be provided upon design and approval of cost. Cabinets, counters and shelving in "lab" will be furnished and installed as per SK dated 5/13/10. Thermal and Moisture Protection: • Exterior walls, fiberglass insulation to be removed to allow electrical and mechanical component installation. Base contract includes full cavity installation of % pound open cell spray foam from sill plate to underside of second floor deck to achieve approximately R13.5. • Fiberglass insulation existing in ceiling will remain and be repaired as needed if damaged during installation of mechanical systems. • Window cavity insulation will be replaced with spray foam in all areas that can be done without damage to window. • Provide caulking at all counters and plumbing fixtures to adjacent walls and floors. Doors and Windows Interior doors to be solid core clear maple factory finished as per The Inside View finish schedule, frames to be knock down steel. ADA approved hardware to include locksets, privacy sets and passage as required, commercial grade. Interior wall windows are constructed using aluminum store front frames. Frames to be fluoropolymer finished metallic paint. Glazing is single strength tempered or clear safety glass. Graphics by others. Finishes: Gypsum wallboard (GWB), 5/8" thickness will be installed over existing wood framed exterior walls and over steel stud framing on all exposed interior surfaces above the floor, i.e. walls, soffits and ceiling in waiting area. Exterior windows will have GWB wrapped heads and jambs. All GWB receiving paint will be taped (3 coats) and finish sanded. If required by code review, one layer 5/8" with one coat fire taping will be installed to underside of second floor framing for added cost of $6,600.00. Radiation shielding or leaded GWB, 4'w x 5'h starting 18" above the floor is provided at eight (8) locations, and all walls in pan x-ray area. Demolish and rebuild (4 stair locations) finished to existing level of stairs is included Flooring as per The Inside View finish schedule material and labor included as well as added floor prep required per site conditions. Moisture testing is included as required by manufacturer and if excess moisture is determined, remediation will be discussed "none expected." • Vinyl cove base, 4" high is included as well as carpet base as per finish schedules. John O'Horo, DMD, PC May 13, 2010 Page 3 Interior painting will be one coat primer and two coats finish on all surfaces. Finishes on all casework will be performed by the casework supplier and determined by finish schedule. Wallpaper supplied by The Inside View installed by MCCI. Ceilings to be 2x2 Acoustical Ceiling Tiles "Dune" throughout with the exception of the waiting area and above the brushing station. The ceilings in the waiting area and above brushing station will be a painted flat drywall ceiling. Included is an allowance of $3,800 for electric fireplace with floor to ceiling stone. Specialties: • Each bathroom will receive one(1) 42" HC grab bar, one (1) 36" HC grab bar, one (1) 18" HC grab bar, one (1) surface mounted toilet paper dispenser, one (1) hands free automatic soap dispenser and one (1) hands free automatic roll towel dispenser in three (3) bathrooms furnished and installed by MCCI. Bathroom mirrors supplied by The Inside View installed by MCCI. • Two (2) 10# dry chemical fire extinguishers in semi recessed wall cabinets. • Any room signs, directional signs, or other signage is not included. • Two aluminum mail boxes (1) three- space and (1) four- space will be furnished and install in first floor entries. Mechanical: • Fire Protection not in contract, fire alarm by the electrician. • HVAC will be provide thru the following: o Two (2) Mitsubishi outdoor compressors and four (4) indoor ducted evaporators (Heat Pumps) o Ducted fresh air intakes. o All duct work including registers, grills and diffusers. o Controls and control wiring. o Refrigeration piping. o One (1) exhaust fan for staff lounge, three (3) exhausts for bathrooms. o Design by contractor and Mitsubishi engineering. o Stamped plans if required is included in engineering allowance. o All ductwork will be insulated as required by code. o Existing disconnected heat pumps will be saved for future use by tenants Plumbing as follows: o Water, air and vacuum piping for six (6) operatory and two (2) hygiene chairs provided with valve terminations at chairs. Connection to equipment at chair and in mechanical space by others. o Supply, waste, vent and air piping to each lavatory in the eight (8) treatment rooms, connection of lavatories is included, supplied by others. o Supply, waste and vent piping, including fixtures, for three (3) bathrooms, each equipped with one (1) ADA water closet and one (1) ADA drop in lavatory w/faucet o One (1) double basin, stainless steel sink w/faucet and sprayer in the staff lounge including garbage disposal, supply, waste and vent piping. John O'Horo, DMD, PC May 13, 2010 Page 4 o Supply and install two (2) drop in lavatories w/faucet and supply, waste and vent piping at Brushing station. o One (1) Hi -Low ADA water cooler, with supply, waste and vent piping. o One (1) 2'x2' floor mount mop basin, with supply, waste and vent piping. o Supply and install laundry tie-in for stackable washer and dryer. Appliance supplied by owner. o Provide supply, waste and vent piping to the Lab and Sterilization/Clean Storage for two (2) sinks and one (1) dishwasher hook-up. Sink/faucet fixture provided in Lab only, balance of equipment by others. Pressurized air supply to lab. o Underground waste outfall terminates in existing space. Saw cut of slab and excavation required for new plumbing by MCCI. Depth assumed adequate to allow use of gravity waste flow to all locations. o Supply cold water piping to water filter and filtered water piping to each chair "owner supplied water filter". o Installed owner supplied plaster trap in Lab. o Connect water supply to owner supplied autoclaves. o Connect air lines to owner supplied and installed compressor. o Connect vacuum lines and discharge lines to owner supplied and installed vacuum pump. o All air lines will be terminated on equipment end with a valve for connection of equipment by others. o Supply and install oxygen and nitrous oxide lines to eight (8) chair locations from owner supplied equipment. o Water service will have a one (1) RPZ backflow preventer. o One (1) 52 gal electric water heater with recirc system. o Waste and vent piping to be sized as required by code; vacuum lines are 1%Z", schedule 40 PVC; water lines are PEX or as field conditions require; air lines are %2" type M copper, insulated with 3/8" wall Armorflex where underground. o All plumbing will be as per Mass plumbing code. Electrical: Power Wiring: • 29 Standard Duplex Receptacle • 5 Standard Double Duplex Receptacle • 12 Dedicated Duplex Receptacle • 8 Standard GFI Receptacle • 2 Dedicated GFI Duplex Receptacle • 13 Standard Duplex Receptacle Tamper Resistant • 2 GFI Duplex Receptacle Tamper Resistant • 10 Hospital Grade Duplex Receptacle Tamper Resistant • 15 Hospital Grade GFI Receptacle Tamper Resistant • 9 Hospital Grade Floor Mounted Double Duplex Receptacle • 7 Hospital Grade Cabinet Double Duplex Receptacle • 1 20A 2P Pan X-ray Receptacle • 1 Garbage Disposal Receptacle/Switch John O'Horo, DMD, PC May 13, 2010 Page 5 • 3 WP GFI Receptacle • 8 Dedicated 20A 120V X -Ray Circuit With Switch • 1 20A 208V Compressor Feed • 1 20A 208V Vacuum Pump Feed • 1 Compressor Control Panel Wiring • 2 Exhaust Fan With Switch (Power Wire Only) Lighting: • • 22 2 x 4 — 2 Lamp Direct/Indirect Troffer Step Dimming • 19 2 x 2 — 2 Lamp Direct/Indirect Troffer Step Dimming • 16 6" Fluorescent Recessed Can Light W/ Cross Baffle • 12 6" Fluorescent Recessed Can Light W/ Cross Baffle And Emergency Ballast • 10 4" Fluorescent Recessed Can Light • 12 Wall Sconce (Install Only — SBO) • 2 Mini Pendant Light (Install Only — SBO) • 2 Puck Light • 1 8'- 4 Lamp Strip Fixture • 5 4'- 2 Lamp Strip Fixture • 2 Fan/Light Unit (Venting By Others) • 8 120V Exam Light Junction Box • 13 LED Exit Sign • 1 Combination Exit/Emergency Battery Unit • 1 Stand Alone Emergency Battery Unit • 6 50W Emergency Battery Unit • 10 8W 12V Halogen Remote Head • 4 8W 12V WP Halogen Remote Head • 34 Single Pole Switch • 10 Three Way Switch • 1 Four Way Switch • 9 Wall Mounted Motion Sensor Switch • 4 3 Ton Gas Fired Package HVAC System (Power Wire Only) Fire Alarm System: • 1 Addressable Fire Alarm Control Panel • 1 16 Zone Radio Box W/ Antenna • 40 Addressable Smoke Detector • 25 Addressable Heat Detector 135 ROR • 20 Addressable Manual Pull Station • 12 Addressable Control Module • 1 8A Power Booster Cabinet • 27 Horn Strobe Unit ADA Compliant • 14 Strobe Only Unit ADA Compliant • 1 WP Strobe Unit • Lot Fire Alarm System Programming 4 - --�l John O'Horo, DMD, PC May 13, 2010 Page 6 Power Distribution: • 4 Relocate/Re-feed Existing 100A 2nd Floor Tenant Panel • 4 Relocate 2nd Floor Tenant Branch Circuit To New Panel Location • 2 Relocate/Re-feed Existing 100A 1s' Floor Tenant Panel • 2 Relocate/Re-pipe Existing 100A 1St Floor Tenant Panel (Future) • 1 Relocate/Re-feed Existing 200A 1St Floor Tenant Panel • 1 Relocate/Re-feed Existing 100A House Panel • Lot $2,000.00 Allowance For Circuit Tracing For Proper Metering Low Voltage: • 10 Coax Jack Outlet • 16 Cat 5e Data Jack Outlet • 14 Cat 5e Data/Cat5e Tele Jack Outlet • 12 Intercom connections to equipment supplied by owner • 16 Ceiling Speaker W/ Integral Volume Control • 1 Speaker Amplifier Other: • Lot Electrical/Fire Alarm Demolition • Lot Temporary Light/Power • Lot Associated Electrical Design Drawing • Lot Associated Electrical/Fire Alarm Permit • NIC: security system, Knox Box General Conditions and Clarifications: • Drawings are included as part of this work for plumbing, electrical and HVACs, each produced by their trade, based on plans furnished by Henry Schien. These will be submitted for building permit after code review by registered Arch. If required plans can be reviewed and stamped by licensed Engineer at additional cost reflected in engineering allowance. • MCCI will provide adequate on site and at office management support to properly staff the project throughout construction to completion. • Daily and final cleaning is provided to maintain job site cleanliness and safety. MCCI will provide an onsite dumpster for use by their staff and subcontractors throughout the project for proper trash disposal. • Temporary power and water will be provided by the building Owner. Telephone and sanitary facilities will be provided by MCCI. • No payment or performance bonds have been included, but are available at additional costs. • Builders risk insurance will be provided by the Owner naming MCCI, their subcontractors, vendors and assigns as additionally insured. • Building permit application and fee is included. The Owner will be responsible for any impact, user, or utility fees not specifically identified as include above. • Moisture testing prior to floor installation is included. Any soils, concrete or other material testing can be performed at the Owner's request at an additional cost. • The testing, removal and/or replacement of hazardous materials is not anticipated or included as part of this work. N.d John O'Horo, DMD, PC May 13, 2010 Page 7 • Work will be scheduled, based on 7:OOAM to 3:30PM, Monday thru Friday (except holiday), five day work week. • All equipment, materials and labor are guaranteed for a one (1) year period, commencing at issuance of a certificate of occupation, Owner occupancy or project completion, whichever occurs first. Any warrantees/guarantees on product/equipment beyond the one year period will be turned over to the Owner for their continuance. • This Proposal is based on the plans listed and the scope of work as outlined above. Should changes be required after code review or at owner's request they will be addressed by change orders. The total projected budget price for the above listed scope of work is $556,202 and will take approximately 14 weeks to complete from start of construction. If the above is acceptable to you please sign and date below and return the signed original to me. MCCI will then issue a contract for the above scope of work. Accepted by Date ` Sincerely,,, � Mark Carrie President ACORQ CERTIFICATE OF LIABILITY INSURANCE DATE 05/28/2010 PRODUCER (603)669-0704 FAX (603)669-6831 Infantine Insurance, Inc. P.O. Box 5125 Manchester, NH 03108 Joyce Dunlap THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Mark Carrier Construction Inc. 175 Lincoln Street, Suite 101 Manchester, NH 03103-5031 INSURERA: Firemen's Ins Co of Washington INSURERB: Acadia Insurance Co. 31325 INSURER C: INSURER D: INSURER E: vvv�rv+vw 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR DD'POLICY NSR TYPE OF INSURANCE POLICY NUMBER EFFECTIVE DATE MMIDDIYYYY POLICY EXPIRATION DATE MMIDDIYYYY LIMITS Verification of Insurance 1 Uji CPA003721922 01/01/2010 01/01/2011 EACH OCCURRENCE $ 1,000,000 GENERAL LIABILITY DAMAGE TO RENTE PREMISES Ea occurrence $ 250,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 5,000 CLAIMS MADE a OCCUR PERSONAL & ADV INJURY $ 1,000,000 A GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO X LOC JECT AUTOMOBILE LIABILITY CAA004640622 01/01/2010 01/01/2011 COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 ANY AUTO ALL OWNED AUTOS BODILY INJURY $ rXXX (Per person) A SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Pei accident) NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY CUA031328810 09/17/2009 01/01/2011 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 X OCCUR F] CLAIMS MADE $ B $ DEDUCTIBLE X RETENTION $ WORKERS COMPENSATION WPA014775915 01/01/2010 01/01/2011 X WRY ATT- OTH- TORY LIMITS ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE� STATES: NH , MA, ME, NY E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYE $ 100,000 A OFFICER/M(Mandatory in N ER EXCLUDED? (Mandatory in NH) MARK CARRIER -EXCLUDED E.L. DISEASE - POLICY LIMIT $ 500,000 If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS "Cancellation Exception: NH Law requires 10 days notice for cancellation for non-payment of premium. CFRTIFIRATF HAI nFR CANCELLATION ACORD 25 (2009/01) V lu88-LUUy ACORij CCiRFuiKtAl lulu. Aiingnis reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED SENTATIVE Verification of Insurance 1 Uji ACORD 25 (2009/01) V lu88-LUUy ACORij CCiRFuiKtAl lulu. Aiingnis reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009101) Mark I Carrier Construction, Inc. 175 Lincoln Street, Suite 101, Manchester, New Hampshire 03103-5031 Phone 603.627.9506 Facsimile 603.647.2270 Worksheet Permit Cost Construction cost (No Furnishings) ------------------------------------ $456500 [3652sgft x $125 = $456500] Furnishings including Dental Chairs and tie in ----------------------$115702 [$556202 "Contract" — carried millwork/furnishings$99500+$16000"chairs"By others] Combined Total cost----------------------------------------------------------$572202 Permit cost O z P" �p w A� v 0 w a z A o a x a aa O w a w A d O x � o w° C/) G ro a w2 � PO4 w a, a�' is w U w W 'ono a�G u cin w C7 C4 w Pa' w v m7 d Z cn v Q a o cn ui am - , :O c v W a C2 cn C.) CL • C n mcc A :CD c moo rt o m cA �L ECO a CD O _ �= v o n E c z ® 0 O o u CD fti c mm y vu CD r^ N m y �/' ev •p z 4: Coc � l0 p °4 m w O a•� m v, m m C/) O! Cn bc�cc � w T y a •_ w Amo m V H O p . Z Cc O •�. vi cap c CS CAmc .o = m o. :o N f- C� .r "' m .L... c W O •Owe.. C� � F- •y LZ C Z WE v •O V •y O C.7 m om;C= 1-' COD O. m- O� q _ ce ` y •� O �- s awm 0 r kwi v 0 0 v qJ r4 A� 0 I cm CO2 O — Cco p� LA O O �E m m 43 CL co O Eft CO ca D 0 L O d CL ca Co S .o o env Q J •� d O � C Z CD CL V CA O C CL C C CO2 0