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HomeMy WebLinkAboutBuilding Permit #445-15 - 4 High Street Suite 118 11/16/2014 BUILDING PERMIT °F po RTM qti tt ao TOWN OF NORTH ANDOVER 3 y 6 °� APPLICATION FOR PLAN EXAMINATION V� Permit No#: 4 Date Received ��Q°RArm �SSACHus�� Date Issued: i� 1 IMPORTANT:Applicant must complete all items on this page LOCATION Urns t' Ll' M lGki S l . l At�€ PROPERTY OWNER �C' 0..A aPrirtt�, Print 100 Year Structure W ye. no MAP_ PARCEL: ZONING DISTRICT: Historic District e �no Machine Shop Village ye , no 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 0 Wetlands ❑ Watershed District ❑Water/Sewer n DESCRIPTION OF WORK TO BE PERFORMED: I' aa:p 01.t-( a E/'I LA o U-C PEC– —1 \C-0 o ty P c�0 \0 s Identification- Please Type or Print Clearly OWNER: Name:n_aan Phone: 6 t I Address: l c-Rnri NL-� Contractor Name: Phone: _ ti — vz� 1�, `b Address:`::5 'acAti o N 0 S -I.- R i Supervisor's Construction License: C,- b`ft SS .Exp. Date: Home Improvement License: 1 1 3 �� _ Exp. Date: t `� I ARCHITECT/ENGINEER S "V1 r1 (4kCHt ii�u URS Phone: 97R — C1 8 — 9 oT :3 Address:_ .TIS SUflHea -51 017 'J r✓ Reg. No. 0 O 8 FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. tb Total Project Cost: $ ®, FEE: $ 201 .6 Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived El. Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swirmning 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 i PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS I CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Siqnature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster o site yes no Located at 124 Main Street Fire Department signature/date COMMENTS /A Com—! Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email i Date Time Contact Name .--"-- ----..._.._._. --.........._. --..... ----...- Doc.Building Permit Revised 2014 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 o Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application � ❑ Certified Surveyed Plot Plan 1 `\ ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/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 thenet this recorded at the Registry of Deeds. One co and roof of recording g g Y copy p g must be submitted with the building application Doc:Building Permit Revised 2014 (( Location--�C"���.� �Wle_ �1 &J'Ptoj �U No. Date a . - TOWN OF NORTH ANDOVER - Certificate of Occupancy $ Dol >. Building/Frame Permit Fee $ Foundation Permit Fee $ 'Other Permit Fee $ ` TOTAL Check# ` 9c) ' U 2.) 3 Building Inspector I .'A0 TN,hrt 0 . SSACN1SEt CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 445-15 on 11/6/2014 Date: December 9, 2014 THIS CERTIFIES THAT THE BUILDING LOCATED ON 4 High Street Suite - #118 MAY BE OCCUPIED AS Tenant Buildout - Acelleron_IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG NA West Mill 4 High Street North Andover,MA 01845 Building Inspector Fee: PrePaid$100.00 Receipt: 28238 Check : 1908 j i I r NORT11 Town of 2Andover No. /4q Zvtw• �O 2614 O LANA h ver, Mass, COCNICNIWICK S U BOARD OF HEALTH Food/Kitchen PER IT T LD Septic System THIS CERTIFIES THAT t � A �k;1� �1t BUILDING INSPECTOR ................................. .. ............... ........ .�.. .... ....... ........... . . ... .... ..... .. . . . �� F has permission to erect buildings on ......... � ..`i .. ,-�` �� ............... ................ RoughINN � �/ �0 to be occupied as � 41!1 A.Cz.. . . .......­*.................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file In this office, and to the provisions of the Codes and By Laws relating to the Inspection, Alteration and d Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR I P • UNLESS CONSTRUCTI . T S Ro gh 0 1/_-/�� 01 Service ................. .. .................................. .................. Final' (, BUILDING INSPECTOR.. v 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 i Until Inspected and Approved by the Building Inspector. Burner i Street No. Smoke Det. t%ORTH Town of 0 0 SE No. �I� '� I y * 0 h ver, Mass, cocNictiew�cw �1' A0R� P4P -y TED S V BOARD OF HEALTH Food/Kitchen PERV) T LD Septic System THIS CERTIFIES THAT 194 ..k��c lit ............ BUILDING INSPECTOR 1 RIIZ— on ............................ ... .. ................ . ..... .......... ....... .. p .. buildings on has permission to erect ........................ ......... ...�1 .. .. .�..........�.�.. 1 " to be occupied as ..... ..... ... .. ............................ provided that the person accepting this permit shall in every respect conform to the terms of the application i���'��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. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Q UNLESS CONSTRUCTI T TS Service ................. ... .................................................... 30 BUILDING INSPECTOR Fi al GAS INSPECTO 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. F � a M{ioi7��( •t i �7S AC Hl1`ES CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 445-15 on 11/6/2014 Date: December 9, 2014 THIS CERTIFIES THAT THE BUILDING LOCATED ON 4 High Street Suite - #118 MAY BE OCCUPIED AS Tenant Buildout - Acelleron_IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: RCG NA West Mill 4 High Street North Andover,MA 01845 Building Inspector Fee: PrePaid$100.00 Receipt: 28238 Check : 1908 � �ORTFi Town of � �. : :. � � ndover ' p r` 0 owlzybVeVWLjV � ?41� oJ_ h ver, Mass, COCKICN!WICKOt S U BOARD OF HEALTH Food/Kitchen Septic System s THIS CERTIFIES THAT � PERVIT �� .tt3eIIgBUILDING INSPECTOR F........................ 4.4................ . ..... .......... . ..... . .. has permission to erect .......................... buildings on !y% � ........ .. 1 .. . .. ................�.�.. Rough e- ►1A�...:� AtAx.. 1�. . . .tobe occupied as ..... ..... � ... ............................ 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough r Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR P • UNLESS CONSTRUCTI T TS Ro h n?�- // - Service ................. ... ...................................................... tFia' 301 BUILDING INSPECTOR A& GASINSPECTO, 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. Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost $ 16,750.00 m $ - $ 201.00 Plumbing Fee $ 25.13 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 25.13 Total fees collected $ 351.25 4 High Street Suite 118 Acelleron 445-15 on 11/6/2014 tenant Expansion NORTH Town of y. : _ Andover 1. .� C, �h ver, Mass, Yew �o A— C OC NIC Nl "C' �oi' 7d AD'4ArED ►PP,�'�5 lS U BOARD OF HEALTH Food/Kitchen PER IT T LD Septic System THIS CERTIFIES THAT otep %I k 3e. I1t BUILDING INSPECTOR ................................1.. ..............4.. ........................ ..... .............. *....... ' Foundation has permission to erect .......................... buildings on ...... � ...`i ...........01 w` Rough to be occupied as .....�.� � ... .. .. .. ............................. 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR OD UNLESS CONSTRUCTI T TS Rough Service ... ...................................................... Final 3 o l BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit ReAuired 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. OFFICE OF BUILDING INSPECTOR • ' TOWN OF NORTH ANDOVER =' Z . CONSTRUCTION CONTROL. PROJECT NUMBER: 1406002.12 PROJECT TITLE: Acelleron Expansion PROJECT LOCATION: 4High Street, Suite 118 North Andover NAME OF BUILDING: West Mill NATURE OF PROJECT: Tenant Fit Out IN ACCORDANCE WITH ARTICLE i 16 OF THE MASSACHUSETTS STATE BUILDING CODE, 1, Linda S. Smiles_ REGISTRATION NO. 1Qg8tt BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT 1 HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ❑ ARCHITECTURAL ® STRUCTURAL ❑ MECHANICAL ❑ I FIRE PROTECTION ❑ ELECTRICAL ❑ OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEGE,SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. _ 1 FURTHER CERTIFY THAT.I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review,for conformance to the design concept,shop drawings,samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become,generally familiar wlth&he progress and quality of the work and to determine,in general,if the work is being performed In a manner consistent with the construction documents. PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY, A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT;A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. G £ SUB C IB D AND SWORN TO BEFORE ME THIS DAY OF N T R �Usuc MY COMMISSION EXPIRES Standard Form of Agreement between Owner and RCG LLC where the basis of payment is the Cost of the Work Plus a Fee without a Guaranteed Maximum Price Date: October 14, 2014 Owner: RCG West Mill' A LLC C/o RCG LLC 17 lvalob Street, Suite 100 Somerville, MA 02143 Contractor: J & K Contracting LLC Architect: $AAM Architects R. Project Name: Acelleron Expansion 4 High Street#'112&118' The Owner and Contractor agree to the terms stated by this contract. This contract supersedes any prior agreements, representations, or negotiations, oral or written. No liquidated damages shall apply to this agreement. This contract consists of the following documents: 1. Obligations of the Parties 2. Contract Sum 3. Project Schedule 4. Signatures Exhibits Exhibit A: Estimated Cost of Work Exhibit B: Project Schedule Exhibit C: Drawings Page 1 of 6 ( t L 1. Obligations of the Parties I Obligations of the Contractor: The Contractor accepts the relationship of trust and confidence established by this Agreement and covenants with the Owner to cooperate with the Architect and exercise the Contractor's skill and judgment in furthering the interests of the Owner; to furnish efficient business administration and supervision; to furnish at all times an adequate supply of workers and materials; and to perform the Work in an expeditious and economical manner consistent with the Owner's interests and in compliance with all applicable governmental codes and regulations. The Contractor shall keep full and detailed accounts and exercise such controls as may be necessary for proper financial management under this Contract. The Contractor shall keep full and detailed records of all books, records, permits, licenses, correspondence, receipts, instructions, data, and drawings associated with the Project including all Subcontractor contracts, invoices, vouchers, insurances, lien waivers, and other correspondence. The Owner and Owner's Accountants shall have access to review, audit, and copy all Contractor documentation. The Contractor shall retain these documents for a period of three years after final payment. The Contractor shall maintain insurance at the following levels with the Owner listed as a co- insured: Type of Insurance Limit of Liability Commercial-Genera I Liabilit $'h;t1Q0,000.00 Upon request, and at the cost of the Owner, the Contractor shall obtain a performance bond up to the total Cost of Work. Such costs shall be added to the Construction Volume. The Contractor understands that the Project will be financed by a construction lender and, then, by a permanent lender. The Owner may assign any of its rights under this Contract to the construction lender and the Contractor hereby consents to any such transfer provided no such assignment shall relieve the Owner of any of its obligations under this Contract, unless agreed to in writing by the Contractor. The Contractor shall execute any certificates, lien waivers, releases, receipts, and other documents as may be reasonably required by the construction lender or permanent lender including a subordination of its mechanic's lien rights to the construction lender's and permanent lender's mortgage or deed of trust. The construction lender for the Project will be: Obligations of the Owner: The Owner agrees to furnish or approve, in a timely manner, information required by the Contractor and to make payments to the Contractor in accordance with the requirements of this Agreement. Dispute Resolution: Claims, disputes or other matters in question between the parties to this Agreement shall be resolved by mediation or by arbitration. Prior to arbitration, the parties shall endeavor to reach settlement by mediation. Page 2 of 6 2. Contract Sum Cost of Work: The Contractor shall provide a detailed estimated Cost of Work to the Owner(see Exhibit A). The sum of these costs, including the fee is as shown below: $1%7x0.00 Change Orders: The Contractor does not guarantee the Contract Sum in any form. In the event of changes to the Contract Sum, the Contractor will present written changes to the owner for costs that exceed the Contract Sum in the form of a Change Order. The Contractor will review all Subcontractor Change Orders before submittal to the Owner and Architect and make a recommendation for payment or non-payment. The Contractor's Fee will be calculated including any approved Change Orders. The Owner, Architect and Contractor will negotiate disputed Change Orders in good faith. Contractor's Fee: 10%of total construction volume. This includes pre-construction and project management services, and field personnel and associated management overhead. The fee is based on actual costs incurred, with final true up, and is billed monthly in arrears. Total Construction Volume excludes permits and fees, which shall be paid directly by the Owner. Construction management labor, standard tools and equipment, and labor-related overhead are covered within the fee. Specialty tools or equipment and any trade labor supplied by J&K personnel shall be charged separately. If a project is terminated or suspended by the Owner prior to completion, J&K shall be compensated for the actual cost of services provided prior to receipt of notice of termination or suspension from the Owner. Subcontractors: The Contractor plans to hire Subcontractors to perform the majority of construction associated with this project. The Contractor shall provide the Owner and Architect information on all of the bids received by Subcontractors and the names of the Subcontractors selected. Owner shall have the right to reject a proposed Subcontractor; however, in the event that this leads to a higher Cost of Work, the Owner shall pay for the difference. The Contractor reserves the right to reject any Subcontractor, even if it is the lowest bid, and to dismiss Subcontractors from the job that have been previously approved by the Owner. Payments: The Owner shall make progress payments on the Contract Sum according to the Requisition process described below. The Contractor shall, at the conclusion of each calendar month on the project, present to the Owner an application for payment(Requisition)for costs incurred during that month. The Requisition shall include all invoices, vouchers, partial releases of liens, expense reports, and any other evidence to support the validity of the Requisition amount. The Contractor may requisition for completed, but unpaid work based on an expectation of payment upon receipt of funds. The Owner, the Architect, or their representatives shall be afforded five 5 business days to review such application and question the Contractor about its contents. In the event there are no disputes, the Owner shall pay the Contractor within 10 business days of receipt of the Requisition. Payment by the Owner does not represent that the Owner or Architect have made a detailed examination of the documentation, inspection of the work, or verification of the accounting. Page 3 of 6 At the completion of the project, the Owner shall make a final payment to the Contractor based on a final Cost of Work with a truing up of fees. If further corrections to work are required that are not covered under warranties with Subcontractors, or that are not the outcome of negligence or poor workmanship by the Contractor, the Owner shall pay the Contractor for any work associated with performing the corrections based on the hourly rate agreed to in this contract. Retainage: The Owner shall not hold back any fees to the Contractor to ensure completion of the work. The Contractor will be expected to hold back fees from Subcontractors to ensure their performance based on the terms below: 10%,of billed costs, unless otRirwise approved by the Owner Termination of Contract: The Owner shall reserve the right to terminate or suspend the Contract at its sole discretion. Within 15 days of termination or suspension, the Contractor shall present an accounting of all its costs incurred for reimbursement by the Owner. If the Owner elects to proceed with the project without the Contractor, the Owner shall have the right to assume the Subcontracts and agreements related to the Project. 3. Project Schedule Date of Commencement: The Contract Time shall be measured from the date of commencement. The date of commencement of the Work shall be the date of this Agreement, unless a different date is stated below or provision is made for the date to be fixed in a notice to proceed issued by the Owner. November 6,2014 or such time.that Notification to Proceedis iven,. y Owner Contract Time: The Contractor shall provide to the Owner a Project Schedule(see Exhibit B). This Schedule is based on assumptions reached prior to the signing of this contract, which assumptions the Contractor shall attempt to clarify in the Schedule. However, the Schedule always assumes the Owner and the Architect respond promptly to requests for information and do not request any significant changes to the construction program. In the event that the Owner or Architect find any discrepancies with the Schedule or its Assumptions, they will promptly notify the Contractor, who shall make adjustments to the Schedule as necessary. According to the attached Schedule, the Contractor shall achieve Substantial Completion of the entire Work as follows: Date of Substantial Cora" letion to be no later than Devember, 15,2014 The Contractor does not guarantee the date of completion. However, the Contractor shall not be entitled to additional fees based on delays in the project unless those delays can be shown to incur extra costs for the Contractor and were caused by the actions or requests of the Owner or Architect. The Contractor shall present an updated Project Schedule to the Owner and Architect on a weekly basis for their review. Page 4 of 6 r 4. Signatures The Owner's representative is: David Stelnbergh�mManaer cI G LLG 17 Ivalno Street,Suite 10Q SomeMIle,MA 02'1'43 § 14.4 The Contractor's representative is: Ri'e—ra n Wh lae n rinc� at � J&K.Contracting" M Richmond Street Weymouth, MA o218s This agreement is entered into as of the day and year first written above and is executed in at least three original copies, one for the Owner, one for the Contractor, and one for the Architect. Owner C ntractor . natur Signature ba at-_ /-e CJ`--- Printed Name and Title V Printed Name and Title Page 5 of 6 Schedule of Values Acelleron Budget General Conditions $ 2,500.00 Demo, inc carpet $ 0.00 Frame board and tape $ 4,500.00 Paint $ 2,000.00 Flooring $ 2,500.00 Electric $ 2,000.00 HVAC $ 1,000.00 Sprinkler $ 0.00 Doors,frames,Hdw $ 727.00 Sub total $ 15,227.00 Construction fee,10% $ 1,523.00 Total Construction Cost $ 16,750.00 Permit $ 200.00 Page 6 of 6 ACCA CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYW) `....�� 7/10/2014 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(ies) 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 DUPONT INSURANCE AGENCY INC NCONTACT AME: 18 COPELAND ST PHONE FAX QUINCY, MA 02169 E-MAILo Ext: AIC No: ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURERA: Liberty Mutual Fire Insurance 23035 INSURED INSURER B: JK CONTRACTING LLC 31 RICHMOND STREET INSURERC: WEYMOUTH MA 02188 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 20858191 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR rypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DDIYYYY MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 71OCCUR DAMAGETO PREMISESSEa occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY F7 PRO F__]LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC2-31S-601698-014 2/17/2014 2/17/2015 �/ SEATUTE I EERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? ❑Y N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION RCG LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE JOB REF#16 CHAUNCY STREET#43 CAMBRIDGE MA 021 8 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 17 IVALOO STREET, SUITE 100 ACCORDANCE WITH THE POLICY PROVISIONS. SOMERVILLE MA 02143 AUTHORIZED REPRESENTATIVE �'*�qL LutJ' Liberty Mutual Fire Insurance ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 20858191 CLIENT CODE: 1644469 Lucy Garfield 7/10/2014 2:19:49 PM (EDT) Page 1 of 1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards r Construction Supervisor License: CS-066334 XURAN T WHET AN •'% 31 RICHMOND ST WEYMOUTH MA 954— Expiration Commissioner 09/26/2015