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59 LEACH ST - BUILDING INSPECTION Ll The Commonwealth of Massachusetts 'RECEIVED Board of Building Regulations and Stari[iat'c�sECTIONAL SERV CES CITY OF Massachusetts State Building Code, 780 CMR SALEM 77 l, �''��t1��ll AA gvisedMar2011 Building Permit Application To Construct, Repair,RenJ94C(06eUlAa eS One- or Two.Fancily Dwelling This Section For Official Use Only Building Permit Number: ^, Date Applied: Building Official(Print Name) j Signature Dale y SECTION 1: SITE INFORMATION r1.1 Property Address: 1.2 Assessors Map &Parcel Numbers 59 Ls.c.c(. 4. UnJI i L l a Is this an accepted street?yes r/ no Map Number Parcel Number I� 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Public❑ Private❑ Check if yes❑ p P y SECTION 2: PROPERTY OWNERSHIP' 2,}1 Owner'ofRecord: Ql`I70 Hwold OIICLAc Name(Print) City,State,ZIP S4 L"L,l 5�. 0 781-S7 ;L-105'd dJ Ak)ma•lk�oo. co,-, No.and Sweet Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK=(check all that apply) New Construction❑ Existing Building 66 Owner-Occupied ❑ I Repairs(s) ❑ 1 Alteration(s) BJ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units_ Other ❑ Specify: Brief Description of Proposed Work :144pl co &kkw ca S. a ioowr S. Q SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1.Building $ !v 1. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2.Electrical $ �SOO h Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ L 9 O O 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5.Mechanical (Fire Suppression) $ Total All Fees: $ - Check No. . Check Amount: Cash Amount:- 6. Total Priijttt Cost: $ J a t j S ❑Paid in Full ❑ Outstanding Balance Due: � 7 � - y7 r - ,27 4' / SECTION 5: CONSTRUCTION SERVICES 5.1 \Construction Supervisor License(CSL) CS — )oS393 It IN Ia017 1,,1t D1A k-1' License Number Expiration Date Name of CSL Holder U �� �^ '� I S 1 List CSL.Type(see below) No.and Street r Type Description t �1 1 I�1(1- O I C6Sj U Unrestricted(Buildings u to 35,000 cu. ft. Wes. 1 i_ y� R Restricted 1&2 Family Dwelling City/Town,State,ZIP M - Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 47g''179- �791 Necs a G0/&lc4s�• /tc 1 I Insulation Tele hone Email address D Demolition 5A.I2 Registered Home Improvement Contractor(HIC) I�3 17 ) Vlr/1017 Iyt.V t1t 5' Nt 4-5 HIC R egistration Number Expiration Date HCComppniyN, orHICRegistrantName IN 3 M64t SF 04 iC� &At cS�'I�S. CA,M No.and Street Email address ce MA 97Vysw- Ci /Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... lif No ........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,as Owner of the subject property,hereby authorize Qo "-t 0 Vrw. D, 4e/, to act on m h y behalf,in all matters relative to work authorized by this building permit application. 14wio lj I,�•fowl cy I Is 1 aot(o Print Owner's Name(Electronic Signature) Date SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. j vat toJ IIS/dOI( Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at mm mass.gov/oca Information;on the Construction Supervisor License can be found at www.mass.eov/des 2. When substantial work is planned,provide the information below: Total floor area(sq. ft.) (including garage, fmished basement/attics, decks or porch) Gross jiving area(sq.ft.) 'Flabitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" i CITY OF SMXA1, \'L-kSSACHL'SETTS BUILDING DEP\RTNEINT .• ' 120 W 1SHINGTON STREET, 3w FLOOR 7ET. (978) 745-959S F.jLx(979) 740-99" KIMffiERt EY DRISCOLL MAYOR DIRECTOR ST.P[ERRB DIRECTOR OF PUBLIC PROPERTY/BUILDING CO%L%aSSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information r 1 Please Print Legibly Name IBusitx'svorgani:ationAndividuall: Nt67 L e_ C0ASV,Jr,41k& l Se/vices LLC Address: N3 Q cis, nbr;Jae. SE. S.aL 10 City/State/Zip: La&01 . /K.4 QdY; Phone #: 978'- W41- ay00 Are you an employer?Check the appropriate box: Type of project(required): 1.2 1 am a employer with `/ 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).' have hired the sub-cantractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.2 ?• 2 Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity. workers'comp. insurance. 9, ❑ Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.0 1 am a homeowner doing all work right of exemption per MGL l i.❑ Plumbing repairs or additions myself.(No workers'comp. c. 152. §1(4),and we have no 12.❑ Roof repairs insurance required:)t employees.[No workers' 13.❑Other comp. insurance required.) Any applicant that thetas box ai mutt also fill out the section below Stowing their workers'compensation policy infutmation. '1hvneowtKas who submit this affidavit indicating they are doing all work and then him outside cootmdars Most auhtnit a new affidavit indicting stick :Contractors that check this box must attached an additional sheet showing the name of the Subsvntmctors and their workers'comp.policy infomutioa. i am an employer that is providing workers'compensation Insurance for my employees. Below is the policy and Job site information. 1 Insurance Company Name: AMtr't'°., z'ar�t:� ury„u Co Policy H or Self-ins. Lic. �11("7�`'i`Io16 Expiration Date: n8117 11; Job Site Address: Sq Ltr..ct. St. OJ I City/State/Zip: Sxlt ,; /V 61970 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 S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form Of STOP WORK ORDER and a fine of up to S250.00 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 covemge verification. l do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Sienat ire: �7 Date, O/ — a';- Phone , 97V - r/SY- e,2rf00 Official use mdy. Do not write in this area,to be completed by city or town ofJ7ciat City or Town: _ -------- 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#: New Edge Construction 'Services LLC 14AR Cambridge 1,A ell, MA 018'2 Phone t911+1454-24(l() License: CS '105101 1lie: 183171 w!\F ll CONTRA(-r r1mov,-lr Trots A�:Kt 8 kti-q kladl m;.Nf lky ytnl t r 14 in th4 Year of'W 1'ictw"ni the(ttvrier: "Thin+tdlk+tanew W 1 catch SI,l6nit 1 Salem.MA 01470 And the Con tor NC% Edge(Inslrueti,+n vices i:-1,f 14',R C:muhridge St 410 Lowell. MA 01852 For the M icrt; Su Leach St. t Init l Salim. NiA 01970 Contract Number, 20151213 This agm-cment is entered into Mvvccu ilan+ld Ml:uny mid Ncrr Edge Construction Services l.l.C.This is also noted in contract docunieots as NFCS,General Corantetor.m Contractor, it is agreed by the panties as t tlh�tirs: Aitrlrt v 1. CONTRACT DOCI UMI:N S I.I. the contract documents consist of this agree mans,general conditions,construction document., scope of work document.construction payment sclxviule, and all addenda issued prior 10 execution ofthis agivenicnt and all change orders or.m.alitications issued toad agreed it)by both pm-ties. All documents n.+Ewl'lxvcin shxtli'lx provided to the Contractor by the Droner: These contract document. repro sent the entire agreement oi-Nuh parties and supersede any prior oral or written ag moment Alirlc l.s 2. SCOPE OF WORK TtM(.'ontnietor agrees lei construct the billowing scope description: 2.1. I1ce.,riptian;ukt ticope of N'ork; i L�Yi�`13stust Prep unit with plastic and raniF tonal to protect during construction. i Remove etitsting kitchen and runtry cahinets. Remove dtyw A111 in elvistiog Nlthnwin5. All debris to he dispowd of in N1 CS dumpster oliritc. lnsudl new kitchen cabinets in existing layout. All appliances turd fixtures to remain in:existing l rations. Add wall to extCnti r~Ni.tintt hat WRI t Ar in huthmortt twit.Initialed by.Cwner Rol Contractor_All 1 Fixed Contract Amount. - Page 2 of 8 Plaster new ceilings in bedrooms: Open ngnstructural walls in second bathroom to add walk-in shower. Add door in existing closet area for bedroom. Move nonstructural wall in pantry to enlarge bathroom and accept tub and shower in bathroom one. Electrical Update electrical in bathrooms and kitchen. Change existing lighting fixtures to new: All fixtures to remain,in existing locations. Plumbino Update plumbing in bathrooms and kitehi tc Remove and install new existing toilets,sinks,and shower fixtures. Alt fixtures to remain in existing locations_ Tice Furnish and install new file floor in bathroom. Eloorimi Sand and refinish all existing,hardwood floors. Eiiig!` i Patch and paint unit as:necessary: I .AHTIC4l:ITIME OF COMPLETION - 3.1. The approximate commencement date of-the project shall be December 14,2014.The approximate completion date of the project shall be February 14,2015.however any change orders and/or building inspectorfdepartment conflicts might delay or otherwise affect the completion date. Additionally, contractor cglinot control delivery schedule of materials;purchased by homeowner which may delay or otherwise affect the completion date: AaTwu.4. THE CONTRACT PRICE. 4.1. The purchase price of the project shall be set at the sum of$12195 00 [twelve thousand one hundred and suety-lye Dollard subject to additions and deductions pursuant to authorized change orders and allowances. 4.2. The Owner and the Contractor acknowledge that the Owner will pay a sum of$4,065.00 Ifour thousand sixty-five Dollars] upon signing of this contract and before construction begins as a deposit and part of the purchase price of the project. ARTICLES. PROGRF,SS PAYMENTS §,I. The Owner will make payi< hts to the contractor pursuant to the attached construction payfffcnt -schedule as work required by said schedule is satisfactorily completed. Owner shall make draw rwithin five 5 days after request by contractor. Should the owner fait to make payments to contractor O Y payment,contractor may charge a penalty of 5%annually upon the unpaid amount until paid. Initialed by:Ownertt!/ Contractor (1 >I Fixed Contract Amount page 3 6t 8 I 5,2. Construction Payment Schedule: • 1hlkposit at Contract Signing: $4,0(t5,00 • li3 After Rough Inspections: $4.065.(N) • Balance as,Progressive Payments Thercaller $ if payment is not-reecived by the Contractor within ten(10)days after delivery of payment ek rand for a i work or terminate the contrat at I work satisfactorily completed.contractor shall have the right to.top yt his option. 'Lerniination by Contractor under the provisions ofthis paragraph shall not relieve the owner of the obligations of payments to Contractor fix that part of the work pertixmcd prior 10such termination. Termination by Owner under the provisions of this paragraph shall;not relieve the Ovwncr 'or'to i e work, rtimriictil h i o{'the obligations of payments w Contractor for that purl of h pc p 1 termination i Axrtc,l.t 6. GENERAL PROVISIONS 6.1. This Agreement shall be governed by the laws of the State of Massachusetts. 6.2. Time is of the essence of this Agreement, 6.3. Contractor warrantees all work for a period of 12 months following completion by the laws of the State of Massachusetts. 6.4. Contractor warramiecs all craftsmanship and vendor supplied materials for a period of l2'months following completion of work. Additional warrantees on vendor supplied materials may exceed this -plod and take effect- pc _ 1 6.5. The General Contractor shall obtain and maintain any required insurance including but not limited to workers'compensation and liability instmince,to cover the Contractor's employees and agents, Certificate of Insurance is available upon,request. 6.6. New Edge Construction Services has not placed any lien or othersecurity interest on this project. { 6.7. All Hume Improvement Contractors shall be registered with the Bureau of Building Regulations and i Standards. Any inquires related to General Contractor's registration,should be directed to: Registration Div lion-Nogram:Coordinator.One Ashburton'Place,Room 1301,Boston MA-02108 phone: (617.) 727-3200 ext. 25234 6.8. This Agreement.shalI be governed by the laws of the State of Massachusetts. 6.9. Job Owner's Rights under the Home.Improvement.Contractor Law(MGL chapter'142A)and.other cotisumer protection laws may not be waived in any way,even by agieetYten(. 6.io. this contract maybe cancelled if it has been signed at a place other than the contractor's normal place of business,provided that Client notify the General Contractor in writing at General Contractor's main office by ordinary mail posted, by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. Aa •icu 7; DUTIES OF TiLE CONTRACTOR 7,L All work shall he in scctvdanee-to the provisions of the:plans-and specifications. All systems shall-be in good working order: 7.3. All work shall he completed in a workman like manner,, and shall comply w7th'alI applieat+te national, state and local building nodes and laws. ,,•• Initialed by:OwnerV) Contractor�� Fixed ContnactAmount. Page 4'of 6 73. All.work shall be performed by licensed individuals to perform their said work;as outlined by law, 7.4. Contractor shall obtain all permits necessary for the work to be completed. 7.5. Contractor shall remove all construction debris and leave the project in a broom clean condition. 7.6. Contractor agrees to execute scope of work layout that is attached in an additional form labeled`:Scope of Construction Services'. 7.7 Alt of the finish items as well as Client's choices(paint color,floorfinishes, wood finishes,electrical fixtures,plumbing fixtures,cabinetry,and etc)will need to be chosen and.in-stock a minimum 2.weeks prior to their installation. Any items purchased by the client are the sole responsibility of the client.That includes but-is not limited to picking,up items,defective retums,errors in shipping and scheduling delivery.New Edge Construction Services is not responsible for any schedule delay due to client providing items. 7.8: The General Contractor agrees to be solely responsible for the completion of the work described regardless of the actions of any third part/subcontractor utitized by the General Contractor. Any communications,scheduling,and payments to the subcontractors are,to be directly handled through New Edge Construction Services. The Job Owner will not engage the subcontractors in any other projects either on their property or other property without the consent of New Edge Construction Services. .Annct,€-8,. OWNER &I. The Owner shall communicate with subcontractors only through the Contractor,, 8.2. The Owner will not assume any liability or responsibility,.nor has control over or charge of construction means, methods,techniques,sequences,procedures,or for safety precautions and programs in connection with the project,.since these are solely the Contractor's responsibility: i 8.3. The owner and or architect will have responsibility for the:approval of all finish related items.Any phase,trade,or product will have the home owners and/or architects approval prior to any final payments are to be made.Any changes that are to be made are the sole responsibility of the contractor. AiMCLE 9. CHANGE ORDERS AND FINISH SCHEDULES A Change Order is any change to the original'plans and/or specifications. All change orders need to be agreed upon in writing, including cost,additional time considerations,approximate dates when the work will begin and be completed,a legal description of the location where the work will be done and signed by both patties. 50°/a of the cost of each change order will be paid prior to the change,with progressive p3ymenM made to the contractor pursuant to the attached construction draw schedule as work requited by,said schedule is satisfactorily completed.An agreement may be rnade by the contractor and homeowner for a alternative paymentschedule and will not be subject to this clause. Additional time needed to complete change orders shall be taken into consideration in the project completion date. I Ai rict E 10. INSURANCE 10 1. The Owner will maintain property insurance to the 1411 and insurable value orthe project location, in case of a fire, vandalism,malicious mischief or other instances that may occur. 101. The Contractor shall purchase and..maintain needed Workman's Compensation-and Liability insurance I coverage as required.by law and deemed necessary for his own protection_ ARTICLE 11. SITE CONDITIONS initiated by:Owner Contractor i • $txmt t':arnai;t Aannaiill ViiWhoud 113, If cmubIiolts are eticounwiled Ill the clntsiraetitIn sm, wInVIt are sghstarl ace or i III lVr "iNO 041C IIt,4 14W%ii- I Vomit hiias of talk 1N•N'n physical conihtions 14aII uansnnI titan are, tvIa%Ji dal lel, mlWwltlly.fronl. lhos o+mlinardv frond to exist ant generally I"e1;Itg111Led ila ndicreill in etlllatl'lll!1latll at liyliaea, the )wner kill pt,+inptIv imcshgale mach coudihoas and, if they dither liallorlulIv And cause an inrreatIc or deere.ast.- in the t'onlracna's cost t4, andPvrlimelctpallvil lor. I+orl n`niugcn ofliny part ofthe work. will neg nuue Willi the C'onh'aclor till cyintad/lc atliaNinliml in the ctuitraaVI NIIIII,et alh•acl little tit'INllh. Awrae-i+-1 L. 11 1114Tlt.#tl: 1.Y,WA!t':1'F', .ANi# A!iURS-1-o—S I I.t, hall potties agree that dealing Willi till mtihWas malerials. wnrtic for ush whips rapines specialized training, pn,ccsses, poia?+nutons anti becosas. Lhrrefun•,unless the scofie offlias agrecararnl inv antis the specille h:aalhatr, thstarl+ruatro, nnlim All Or transiximalion of hatanlons lnaderiaN. waste tat 11alte-SIONt nlNtn dlwt•ovem of such hatarthnis m:ttcrials'the 0111trarclor shall utinlV the t hvncr i nnx duuely and allow the t lwner or Conlra tm,to conint i Willi n 11win-dy lncrtstl and tfuaalified lilt/I11Ylnit9 material eontrricwr. Any slat+h w,ort.Niallir he netted as a Change Ostler resahing in additional cells and tale cons<loratitnt3. Aarwl.e..lk ARRITRATIONOF DISPUTUS 111. An txotdnivelNc tie claim arising oat of or rclming ill this conlniel„tit the hrvach theacn4; Nhaal tic set tell by arl,ittlniola at11111t11a1e1>hl by the r nsvriom Arbitration Aastieialion under its Comirnelion Industry Arhitt.nton hides,and judgment till the awantl mildercd by the arbilrat or(s)Italy he colered it, 6ny4:01111 tut,ins .i uristlita ion thereof. Atrrir.i i, 14. WARRANTY 14.1. At the completion of dris pit,m.Coutruetor mhull execute till instrtancut to Owner warrttalinit the pntitm tor period of ono I l)it'll near IKast construction completion(MA construction vtandunla and mla la ).against tieliets is workmanship or materials Ill iGiod, Flic nuuaulnelurnr's W11 ritnly Will prevail. ,14.2. i'anlratator wamtnMcs att ctxttsiuunship anti venthor supplic auatunnls that apply tier it jwriod of 6l) months li,llotl=iltg.otanpli:Gun of work, Additional warrantees till vendor supplied matcrtuls may exceed this Retied and take ctli.cl. Aiti'n"t , li, "!'F:RMfNAI't(iN (1F''1'IiF;C'WN'CItA("f 15.1, tihtiuld the UiVaef or C'ontraitor rail to enrry till(, this eontract,'will%all of its provisions, the Collowing aptuins and slipulaiiops 81111.11 aafgdya 15j.1. if the owner or the Cowmcaor:shall default on the contra lct. the nun-defaulting patty nuly declare the contract is in dctitult and pntceed alpiinst the delaullinh panty for the iveovery of till durnages inrurtra Its a result of%aid breach of contract, including a reaisomhle allorncy's fee. In file case of tie Ill lilting owner,the Uirticst moncy herein mentionatt shall be atl+fllied to file legally ascs:rutin<tt dtlnuigcs. I5;1.2. In the event of dcfMilt by the Owner or Contractor. the non-defaulting party may state his intention it,comply with the contract and pntctxd'kar spccitio Ixrliirmalnre. let.1.;.in the eww of a defaulting owner, the Contractor may accept.at his option the curliest money aN shown hrrtin as litliiiduhvfdamagcs,should earnest money not cover the expenses tit tithe, file t'gmraa tt?rtnay ttutl.c t(aloft do thetatiticr tijr alit-tvt+rl txt.irttd ant,(, fit p!kirvtt lean vylt�)rt l?Ct 1. tit etivIii,ra a1, materials, hotels.conaniction eyuiptncnt and machinery, inclnding reasonable overheatl.'protit anti-dtuuares applicable to the propeily less the earnest money. Akiwi,► tb A9'Tl1KNFY FF:F:V. Initiatixt by:Owner I0 Gwltractor Flied Contract Amount Pop aof8 1¢.1. In the cvcntaf any arbitrntinn or litigation relminp,to the projcct,,project perlinntnnee or this cnniryUl• the prevailing party shall be entitled to roasonabic uttoroey fees, earths and expenses: Au'ru5,r. 17: AC:<`F.:1"1'ANCE-ANDOCCIIPAWN 17.1. General Contractor Arhitrutioli: The General Contractor and Client mul'ually {three in the'ncceptance flual in the event the Y ien—itl C intractor hm a dispute concerning this contract• the-(icneral Contructor mrty submit the dispute to a.private arhitration firm which has hecnapproved by the ticcrelnry cri the EXecutive Office of Consumer Affairs and Burins Regulation Hod the clmswner ihnll be required to submit to such arbitration as provided in the Massachusetts Cenral Law Chapter 142A. 17.2. If any part of this agreement is adjudged invalid, illegal or unenforceable,the remaining parts shall not be affected and shall remain in full force and effect. 17.3. This agreement sball be binding upon the parties,and upon their heirs,exmutoks, personal representatives, administrators and assigns. No person shall have a right or cause ofaction arising out of or resulting from this agreement except those who are parties to it taxi their successors in interest. 17.4. This instrument, including any attached exhibits and addenda,constitutes the entire agreement of the parties„ No representations or promises have been made exc:cpt those that are set out in this agreement. No oral agreements are included in the contract. This agreement may,not he modified except in writing signed by all the parties. No work shall begin prior to the signing of'the contract and transmittal of its copy to the Job Owner. 17.5. Upon completion; the project shall be inspected by the Owner and the Contractor,and any repairs necessary to comply with the contract documents shall be made by the Contractor. 17A 114[honer shall_not s¢II the.property until final payment has been reru ivied by the Contractor. 17.7. Occupancy of the project by the Owner in violation of Article 17.6shall constitute unconditional acceptance of the project and a waiver of any defects oruncompleted work. WtrnFss our hand and seal on this day of_ e 20_ Notice: The signature of the patties above applies only to the agreement of the parties.to alternative dispute resolution initiate by the contractor.'The job owner may initiate alternative dispute resolution even when the parties do not separately sign this section. Initialed by:Owner Contractor�� i t i f 1 i E I 1 Massachusetts Department of Public Safety Board of Building Regulations and' :Standards License: CS-106393 Construction Supervisor ROBERT B VANDINTER „'" E 19 INLAND STREET g LOWELL MA 01851 i C y Expiration: Commissioner 11114t2017 i e t I Vyq� t i s f F t t t t� t t i i f F 12r{ 15 office of Consumer Affairs&Business Regulation-Mass.Gov The Official Website of the Office of Consumer Affairs&Business Regulation(OGABR) Consumer Affairs and Business Regulation l Horne Consumer Rights and Resources Home Improvement Contracting t IC Registration Complaints 'Registration# 183171 Home Improvement Contractor Registrant NEW EDGE CONSTRCUTION SERVICES Registration Home Page `Name RACHEL VAN DtNTER Address 143 CAMBRIDGE ST SUITE 10 City, State LOWELL, MA 01852 Zip Expiration 09/08/2017 i Date i Complaints Details jNo curll:isints found fc7s•this registrant. t 1You can also view arbitration and Guaranty Fund history. Back To Search 16 2012 Commonwealth of Massachusetts. I rvlass.Gov®is a registered service mark of the Commonwealth of Massactiowts. 1 t 4 F {i ajL t jV k Qt f ill hops!/services.oce.statemauslh cnicdBtmis.spx?MSwrchLN=86 69 _.. CERTIFICATE OF LIABILITY INSURANCE uATErnnnnroDmrY' TIFICATE 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. THE CERTIFIC TE H -O IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the poiicy(les)must be endorsed. it SUBROGATION IS WAIVED,subject to e terms and conditions of the policy,certain policies may require and endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endomemen s. PRODUCER CONTACT NAME: _ CLOUTIER INS AGENCY PHONE FAX 1996 L.AKEV IEW AVE (A/C.No,.Est)- (A/C,No): E-MAIL _--- DRACUT,MA 01826 ADDRESS: 28YYX INSURER(S)AFFORDING COVERAGE NAIC 0 INSURED INSURER A: AMERICAN ZURICH INSURANCE COMPANY VANDINTER,RACHEL DHA NEW EDGE CONSTRUCTION INSURER B: SERVICES INSURER C: INSURER D: 143 R CAMBRIDGE ST.#1.0 INSURER E: LOWELL,MA 01,852 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS ISTO 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 MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL WE TERMS,UMU31ONS AND CONDITIONS OF SUCH POLICIES. LINTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MM1DmYYYY). (MKDDiYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMAGE TO CLAIMS MADE a OCCUR. PREMISES(EaENTED oownrence) $ MED EXP(Any one perwn) $ ERSONALM,ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 0 PROJECT E]LOC PRODUCTS-COMPIOP AGO $ L., AUTOMOBILE LIABILITY - COMBINED SINGLE $ _ ANY AUTO LIMIT(Ea acadent) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per Person) HIRED AUTOS BODILY INJURY 8 (Par accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per a, UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIMB CLAIMS-MADE AGGREGATE IS DEDUCTIBLE Is RETENTION.8 1 1 1$ A WORKER'S COMPENSATK)N AND 7 X WC STATUTORY OTHER EMPLOYER'S LIABILITY YIN UB-OG244289-15 08MV2015 08/17/2016 LIMITS ANY PROPERDORMARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBEREXCLUDED? ((Mandatory In NH) E.L.DISEASE-EA EMPLOYEE 8 100,000 U yes,desalt under E.L-DISEASE-POLICYLIMIT S 500,D00 -CESCRIPTIONOF OPERATIONS below DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIRESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE WORKERS'COMPETNSATION POLICY DOES NOT PROVIDE COVERAGE FOR VANDINTER,RACHEL. CERTIFICATE HOLDER" -CANCELLATION CITY OF SALEM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED 120 WASHINGTON ST IN ACCORDANCE WITH THE POLICY PROVISIONS. 3RD FLOQR gUTHORI2EDREP TA SALEM,MA 01970 � � � ACORD 25(2010105) The.ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. All rights reserved. ,4coiz©® CERTIFICATE OF LIABILITY INSURANCE °""` 2i4'15 _ _ 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 ISSUINGINSURER(S), AUTHORED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: N the certificate holder is an ADDITIONAL INSURED,.the policy(es) 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). - IYtooucEa CONTANAIIM: Maria Carson Cloutier Insurance Agency PHONE1. f978I 957-4881. PA%.N (978).'957-7230 1996 Lakeview Avenue .Mal DORESs: mcaraon@insuxex.com Dracut, MA 01826 INSURER(S)AFFORDING.COVERAGE NAIC# ---_-_---_--�—__.._ _---.- INSURERA:Utica First INSURED .ANSURER:8: Rachel Vandinter INSURER C: DEA New Edge Construction Svcs INSURERD: 143R Cambridge Street #10 INSURER E: . _ Lowell, MA 01852 1 INSURERF: COVERAGES CERTIFICATE N UMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCES.OF INSURANCE.USTED.BELOW HAVE BEEN ISSUED TO THE INSIIREO,NAMED ABOVE FOR THEF'OLICY.PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR 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. TPEOFINSURC DDS UNITS � �POLICY NUMBER M A& A GENERAL LIABILITY ART 5074474 OD 8/18/15 S/18/16_EACH OCCURRENCE8 1 000 _OOD Tf CONMERCULLGENEPALLIABILITY I DAMAGE TO RENTED_(Ee.pgyRffir® $ 50 ODD CI.AM-MADE aOCCUR MED 10(AM ore P"SM). $ 5,000 PERSONAL&ADV INJURY $ 1 ODD 000 GENERAL AGGREGATE $ _2.000,,000_ Oxu 'LAGGREGATE LMITAPPLIES PER PRODUCTS-CON1P(DP AGG $ 2OOO 000 POLICY PR4 LOCAUTOMOBILE LIABILITY I NB INED SINGLELIMIT S.—._-- ANYAUTO 'BODILY INJURY(Per person) '$ Al-LOIANED SCHEDULED BODILY INJURY(Per=Jdwt) $ AUTOS PROPERTY DAMAGE HIREDAUTOS _ AUT SWNED , UbHNEILA LJAB OCCUR EACH OCCURRENCE $ EXCESSLIAB CLAIMSMADE AGGREGATE $ DED RETENTION $ K COMPENSATION AILIT WC SrAN- OTH- WORKERS OM , AND EMPUJYERS'UA&UTY �"�""' ANY PROPRIETORIPARRJER/EXECUTWE Y�I. N/A I EL EACH ACOOEM OFFICERWNeER EXCLUDED? _I Cuartlebry in NH) E.L.DISEASE-EA EMPLOYE $ Kyyeess MPTION OF O DEBCRIP170N OF OPERATIONS tiebw E.L.DISEASE-POUCY LIMn $ 1 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES tAeeeh AOORDIOI,AdBdonal Remrin Sehedute,ifm spa WMgdad) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE -EXPIRATION 'DATE THEREOF; NOTICE WILL BE 'DEI]VERELI N City Of Salem ACCORDANCE WITH THE POLICY PROVISIONS. 120 Washington St. AU PRESEiTATNE Salem, Floor alem, MA 01970 (0 1988,2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) _ The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: necsoffice@gmail.com i CITY OF S.UH.M. NLksSACHUSETTS Bu=IIING DEP kRTN1&NT • P• 130 WASHLIIGTON STREET, 3'D FLOOR TEL. (978) 745-9595 FAX(978) 740-9846 KiNiBERLEY DRISCOLL MAYOR Ttior w ST.PmRRE DIRECTOR OF PUBLIC PROPERTY/BUILDLNG CO\LNUSSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit # is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 41 i, S. 150A. The debris will be transported by: (name of hauler) The debris will be disposed of in : (name of facility) /y,7 e Qli Q Sf /-vx (address of facility) signature of permit applicant date dcbriulT.diw