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2A LINDEN ST - BUILDING INSPECTION (2) 1 The Commonwealth of Massachusetts FOR Board of Building Regulations and Standards h_u NI 11NICIPIP:AI.I'I'1' I1 A Massachusetts State Building Code. 7SO CMR, 7i' edition USE Building Permit Application To Construct, Repair. Renovate Or Demolish a Rett+cd•iuttuarc One- or Tiro-Fontih, Duelling /. 008 is Secti n )r Official Use Only Building Permit Nu her: Date Applied: Signature: - y Z Z ui Commissioner/ I ector of uildings Dme SECTION 1: SITE INFORMATION 1.1 Pro erty Address: 1.2 Assessors Map & Parcel Numbers I.la Is this an accepted street? yes_ no Map Number Parcel Numher 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq It) Frontage (it) 1.5 Building Setbacks (ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided i 1.6 Water Supply: (M.G.L c.40, §54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Zone: _ Outside Flood Zone? Public ❑ Private❑ Check if yes❑ Municip al ❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner of Record: Name (Print) Address for Service: Signature Telephone SECTION 3: DESCRIPTION OF PROPOSED WORK' (check all that apply) New Construction ❑ Existing Building ❑ Owner-Occupied ❑ Repairs(s). Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units_ I Other ❑ Specify: Brief Des tion of Pro ed Work': SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ 3c� — I. Building Permit Fee: $ Indicate how fee is determined: ❑ Standard City/Town Application Fee 2. Electrical $ ❑Total Project Cost' (Item 6) x multiplier x 3. Plumbing $ 2. Other Fees: $ _\ 4. Mechanical (FIVAC) $ List: CA 5. Mechanical (Fire $ Total All es: $ Suppression) Check 6s�3 Check Amount,5 Cush Amount: 6. Total Project Cost: $ 3 �j�Q� 11 Paid in Full ❑ Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) a5 ✓70 gf`� r7-2 fi o� License Number E.x1,natio Dale Nano of CSL- Holder List CSL Type (see below) 00 O \-490 X / 7 A,dd _ F Type - Description C u Unrestricted (Lill to L R Restricted INe3 Family Dwelling Signature M Masonry Only �� RC Residential Rooting Covering Telephone, WS Residential Winduw:md Siding SF Residential Solid Fuel Bumine A)tli:mCe Inst:dl:uiun D Residential Denxrlilion 5.2 Re tsterecyHom I rovem n[ Con rac[or (HIC) %.�� iy2 J. /V P eQ3 HI Company ❑me or HI/ 7%�C �tst a Name Registration Number Ad s y —7�6 Expi ation Date Signat Telep ne SE ION 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 .......... No ........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, ACL6�!d ae �S /7 !tn /%IJLL/-r/6" , as Owner of the subject property hereby authorize A- � )00 d 4/64 iai/e' to act on my behalf, in all matters relative t ork authorized by this building permit application. s�� //mil i nature of Owner Date SECTION 7b: OWNER' OR AUTHORIZED AGENT DECLARATION as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and be Print Nam ignature of Owner ot7Autfiorized Agent Dat� (Signed under the pains and penalties of perjury) NOTES: _ 1. 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 and Construction Supervisor Licensing (CSL)can be found in 780 CMR Regulations l 10.R6 and 110.R5, respectively. 2. When substantial work is planned, provide the information below: Total floors area(Sq. Ft.) (including garage, finished base mendattics, decks or porch) Gross living area (Sq. Ft.) Habitable 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" CITY OF SALEM PUBLIC PROPRERTY DEPARTUEW ♦.VYta d' A&A'IL NW& I�t1.�e N::.itf.7�aT• iy.1rA�Y:M dt111��4 Tn.~4&4m •f.%*97�N6lW Coastruction Debris Dts""i Affidavit (requital tar all danolidos and gam adion work) in uteordsms with the six&od dos otdw Sets ItluUWS Codst,M CNIR section 111.E ocbri4 wd dw provisions of M. CL a A4 S Sk -- 13 iidin4 remit 6 _ is(snwd with the eoodWon that dw debris raaldnS ties this wort shall be disposed of in a peoprrty licensed waste disposal (totality as de inad by WX a 1I1. S13" The debris will be transported by: Q - r inane of hauled the Jcbris will be disposed or in : fa l uartw uP fxit�ty� - /�— CITY OF SALEM PUBLIC PROPRERTY DEPARTMENT musr Orly UsmA LL Ittsits 12Crrwue:eaMNSUMr4Sittist.N SIACIn1.0rlrs01970 'ru:97L743.9593 a F.tx:9M74C.9a46 Workers' Compeasadon Insurance AfOdavit: Builders/Contractors/EleetridaiWPMmben Appligant Information Please Print Letibtv NametgucitsUX)rppanirariavlttdtvabaal): •� U� L Address: O - Ii- (Q / City/star¢/Zip:� S0,1P T H A3079 I'lwae r: 9 — Are Y4104n,anspleyer?Check the appropriate boa 'type of project empbyor with L 4. 0 1 am a Scats(conuaetor and etryaluycex(roll Ansitur p rt-dme).r have hired the sub-contractors 6' ❑ �'ew wt 2.Q I am a sole proprietor or panoor- listed on the attached sheet t 7. litt� ship and have no employer rheas ma K- traerors have V. ❑Demolition working for me in any capacity. workers' comp. insurance. q ❑Budding addition [Igo waters'comp. instrranet S. Q We are a corporation exercised d t it 10.Q Electrical repairs or additions required] otl'trxrs have exerciatx!their 3.Q 1 am a homeowner doing all work right of axemptian per MGL 11.0 Plumbing repairs or a lditions myself. (No workers'comp. c. 152.j 1(4).and we have no 12,0 Ruof repairs insurance required.j t employees.(No workers' 13.❑Other comp. insurance required.) •Aiq,Vbrml aro chocks boa el awa alto fin out the warm b6low rhowiag IbAr w t@W cuage alka puliry iofinstation. 'Ilw.atwrtwa who sabots dux amdwu indkatute d"ate louts an work Nd than ltbe oosia cost lain aw".uhmit a tww amJavit indiattins.nee. �Curerxtun do teems this boa mum anadw a additions!Am.howwo the nave area aad chair wortars'ivy.policy utlbroutioa 1 am an eotp/oyer that h providing workers'coorpeasadoa insurance jar my etaployeam B410w Is the purity and Jos silo ia�artaatiuA L / Insurance Company Vame: ,///✓/ nn Policy 4 or Self-its. Lie. M:� ,2,3 5, 7 �� Z Exp rrtton Date: �3 t7 lobSife .idtkcas: s_ _ -r/�/l�l1C.)1&Ah� � CItylSIAVZlp�',,SL7Z jA40117U Attack a copy,of the workers'compensatlon policy declaration paste(showing the policy number and expiration tLte). I-ailuru to secure coverage as required under Section 25A of.1GL c. 152 can lead to the imposition of criminal penalties ura fins up at S1.300.00 and/or one-year impristmrncnt,as well as civil penallies in the form ofa STOP WORK ORDER and a fans of up to S250.00 a Jay against the violator. lie advised that a copy of This statcutent may,be forwarded to the Office of n t .. tau rats of the DIA .or insurance atvvrayc verification. I do hereby reni/y andor a aiax and penalties of par/ury Chet the in/oratuden provided above is trai rid rorreet {i..aan,r - . T3 3 d 0ffW r axe owlyt Do war write/at fhh area.to 6c casrpletd by dry or toww o/Jlelai City or raven: PcrmiVIJeense M hsuing Autburity (circle one): — I. hoard url(ralth 2. Building nepartmcnt J. Ciglfowa Clerk J. Electrical laspcetor S. Plumbing Inspector 6. Other Cunlaet Per oil: _ . ._ Phone p: Information and Instructions for their eggilliloyees' %lassachw m etis General Laws chapter 152 requi all employers die et providewor cice anothercompensation any oamad of hits Pursuant to this stands.an eaylyes is defined as"...every person eapress or implied.Oral or writteL" An e*p1ayer is deRaed a"as iadvidss4 P tR aWeialla&corporation or Oder IeQal entity,or any two or meta Of the foregoing engaged is&Joist enterprise,and including the legal fcPlawntaaves of a deceased employer.or olio usaoisno&or other legal entity.employing employees' However the receiver or trustee of as individntal.o morparmee sin a and who resides therein.or the occupant of tits owner of a dwdtisg house bavimg no smote than three apartments dwoili%house of another who employs Persons to do maintenance.cuastruccon or repair work on such dwelling house or on the grounds or building appurteses thereto sW not because of and mtploymmt be deemed to be an employer." .%tGL chapter 152. ¢25C(6)also states that..every state or local Ikessfsg agosey shag withi eY the►ssues"or too rate a bursas or to construct bsildlegs te the commoawea"fir say Applicant"be it"nor peed reawel of a grease or pert�ed acceptable w a ldsnce of eoespi se with the insurance coverage required." Additionally.MGL chapter 1 S±.$2SC(7)Osseo"Neither the commonwealth not any of its political subdivisions shag enter into any contract for the performance of public work `anal acceptable evidence of compliance with the insurance requirements of this chapter have has presented to the contracting authority.- Applieaau Please till out the workers' compensation Ifisdavit completely.by checking the boxes that apply to your situadoo sod if necessary,supply sub.Aornnactor(s)name(s).address(es)and phone nurnber(s)along with their certificates)of ne L or Limited Liability Pamership$(LLP)with no employee oohs than olio members. rimmed Liability required (L workers'compemttm insurance. if an LLC or LLP doe have employmembers or panniers.are not rd. as d to carry of Industrial employees.a policy is required. Be advised that dnu affidavit may be submitted to the Department Accidents for confirmation of insurance coverage. Alto be sure to sip and duce the aRMavlL 71te affidavit should be returned to she city or town that the application for the permit or licems is being requested. not the Department of Industrial Accidents. Should you have any quesaoss regarding the law-or if you a required to obtain u work en re ' compensation policy.please call the Department at the number listed below. Self-insured companies should enter their ,elf-insurance license number on the avOrOPriM lime. City or Town OfHalshl Please be sure iliac the affidavit is complete and printed legibly. The Department has provided a space at the bottom. of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applimL t'lease be we to till in the permit/license number which will be used an a reference number. In addition,an applicant that must submit multiple pennitilicense applications in any given year,need only submit one affidavit indicating current policy information I if necessary)and under"Job Site Address"the applicant should write"all locations in_(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be prov guru o the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit most be tilled Out each yew. Where a home owner or citimn is obtaining a license or Permit not related to any business or commercial venture t i.e.a dug license or Permit to bum laves Ate.)said person is NOT required to complete this affidaviL IN: 01 ti.x Jf lnvesti,uiuns would Cue to thank you in advance for your cooperation and should you have any questions, :case Jo not hesitate to give us a call. The Dcpanment's addrem telephone and fax number. The Commonwealth of Massachusetts Depaftment of Industrial Accidents OBlee of Iavesdpde" 600 washi08ton Street Boston. MA 02111 Tel. N 617-7274900 ext 406 of 1-877-MASSAFE Fax N 617-727-7749 ,t:v scd 5-26-O5 www.mm.gov/dia zLzzzazzz� nd Standards 'ward of Building Regulations 'r Oonstruction Supervisor License License: CS 70882 Birt Expiration: 7/28/1956 2009 Expiration: 7128/2009 Trli 16025 Restriction: 00 RICHARD J SMITH PO BOX 1769 SALEM,NH 03079 Commissioner Board of Building Regulat ons and Standards One Ashburton Place - Room 1301 lug Boston, Massachusetts 02108 Construction Supervisor License License CS: 70882 Restriction: 00 Birthdate: 7/28/1956 Trp 16025 Expiration: 7/28/2009 RICHARD J SMITH PO BOX 1769 SALEM, NH 03079 Update Address and return card.Mark reason for change ❑ Address 0 Renewal [] Lost Card OPS-CA1 is 50M-05106PC8490 1 ` 1pp � 'e o ui dmg egulati'ons`�an ards One Ashburton Place - Room I 3 0 1 Boston. Massachusetts 02106 Home Improvement Contractor Registration R Igistration: 106603 Type: Private Corporation Expiration: 7/24/2008 AJ WOOD CONSTRUCTION, INC: Richard Smith _- 5-7 DELAWARE DR SALEM, NH 03079 Update Address and return card.Mark reason for change. Addressi [—j Renewal ` Employment - Lost Card DPSAAt 0 50W05iG-PCs490 _.___.---_.- _ �a/te 'lJmvt�X09uOval�le o�✓b�:ki2CltGdvlQ Board of Building Regulations and Standards License or registration valid for individul use only p HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: q Board of Building Regulations and Standards Registration: 106603 One Ashburton Place Rm 1301 IF Expiration: -.7/24/2008 Boston,Mo.02108 Type: Private Corporation I AJ WOOD CONSTRUCTION.INC: Richard Smith _� Not j} 5-7 DELAWARE DR "'�- t— SALEM,NH 03079 Deputy Administrator Not valid without s�goature 00010553 - C E R T I I C A T E O F I N S U R A N C E Issue date: 5-16-07 -Producer This certificate is issued as a matter of information only and CESI Agency of New England confers no rights upon the certificate. holder. This 10 Chestnut Drive Unit E certificate does not amend, extend or alter.the coverage Bedford . - NH 03110 afforded by the policies below. COMPANIES AFFORDING.COVERAGE . Company letter A Nautilus Insurance Insured A J WOOD CONSTRUCTION CORP Company letter B P.O. BOX 1769 SALEM NH Company letter C - - 03079-1769 Company letter D Company letter E - - - COVERAGES This is to certify that 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. Cc Policy Policy - Lt Type of Insurance Policy number Effective Expire ALL. LIMITS IN THOUSANDS GENERAL LIABILITY - General aggreg ate... . . .$ 2,000 A X Commercial General Liab. NC644174 5-16-07 :.5=16-10B Products-completed Claims made - operations aggregate_ .$ 1,000 X Occurence . - Personal & advertising injury. .. .$ 1,000 Owner's & contractors - protective Each occurrence. . . . . . . .$ 1,000 - Fire damage (any one fire! . . . . . . . . . .$ 50 - Medical expense (any one person) . . . . . : .... . .$ 5 AUTOMOBILE LIABILITY CSL - $ An .auto All owned autos - Bodily Injury Scheduled autos - (per person) $ Hired autos Non-owned autos Bodily Injury _- Garage liability (per accident) S - - Property damage S EXCESS LIABILITY Each occurrence Aggregate Umbrella form -_ Other than umbrella form $ S. WORKERS' COMPENSATION Statutory, - AND - $$ -(each accident) (disease-policy c EMPLOYERS' LIABILITY 9 (disease-each ) OTHER - - Description of operations/locations/vehicles/special items CONTRACTOR-WORK PERFORMED BY EMPLOYEES IS CARPENTRY & ROOFING. ALL OTHER WORK IS PERFORMED BY SUBCONTRACTORS. - Certificate holder CANCELLATION Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail.10* days written. notice to the certificate holder named to the left, but failure . to mail such n ice shall impose no obligation or liability of any kind upon hefGYo—n1Rany,t i/t�vagen'ts or representatives. Authorized re e"191* veF / , f �. tic v L c d"o-M o __ ' (OMN17 CERTGA-830409/8705161358) ACORDTM CERTIFICATE OF LIABILITY INSURANCE '�20/220/200 02/ 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Matthews Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1B2 Parker Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lawrence, MA 01843 97B-681-1112 INSURERS AFFORDING COVERAGE NAICS INSURED AJ Wood Construction, Inc INSURER A: LXIiertY Mutual Ina - INSURER S. P.O-Box 1769 INSURERC: Salem, NH 03079 NSURER 7 1-603-235-7 62 4 INSURER E COVERAGES 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. o POLICYNLMM POLICY EFFt'CRVE MnON UMTS GENERAL UABLLIIY MAGOREGATE f COMMERCIAL GENERAL LIABILITY i CLUMSMAADEED OCCUR non)JURY ATE i GENL AGGREGATE LMR APPLIES PER AGG S Pq.ICY LOC AUTOMOBN.ELJAGLRT COMBWF1M SAiGLELNYT ANYAUTO Weaccid"U f ALLOWNEDAURIS DO IiLyLWUFA. SCHEDULEOAUTOS (PnP.aPnj f HIRED AUTOS BODLYINIURY NDNa NNEDAUTOS I—flIXI" f PROPERTY ORANGE i (Pereode o GARAGE UAIUTY MITOONLY-EAACCOENT S ANYAUTO DTMERTMAN EAACC i AUTOONLY' AGG S FXCESMI ERELA LIABILITY EACH OCCURRENCE f OCCUR CtAImSm DE AGGREGATE S f DEOUCIIBLE f RETEmm" i S WORHfRSLIXNPENIIATIONAW WCSTATIF OTH- EWLOvvLvuABIDTY WC231S353819027 02/23/08 02/23/09 EJ.PALHAGGIOENT S100,000 �yee fm E.L.DISEASE-EA EMMOYEE aSOO, OO SPECIAL P—ROV191ONS DNM E.L.OISFASE-PODGY LIMIT S1 U, UUU On16t OESMPRONOFOPERAnoNSILOCAnONSIVBFCLEBIEXCLUHN SADGWBYBJDDRWMW)SPECIALPRDMKM CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DWCIMBW FOUPEE RE CANCELLED BEFORE THE DURATION GATE TIERLaF.TIE IBBLARO INLUIIER NHL WOEAVOR TO MIAIL —DAYB NWTTEN NOTICE TO WE CBnIRCATE HOLDER NAMED TO TIE UFTY.BUT FAILURE TO DO RD SHALL SAMPLE IWOW NO ODOGATION OR LMMM OF ANY OND UPON THE MJOIRBL RS AGENO OR REPRE99WATNM AVTMfaQED REPPIF3BlT ACORD21(2001108) - ®ACOROCORPORAMON18641 10 39Vd SNI SM3111dW 99SES89BL61 9Z=ZZ 800Z/ET/10 QTY OF SALEM DEPARTMENT OF PLANNING AND COMMUNITY DEVELOPMENT KIMBERLEY DRISCOLL MAYOR LYNN GOONIN DUNCAN,AICP 120 WASFUNGTON STREET♦SALEM,MASSAO[-IUSETTS 01970 DIREcrOR TEL:978-619-5685 ♦FAx:978-740-0404 HOUSING REHABILITATION LOAN PROGRAM OWNER - CONTRACTOR AGREEMENT FOR REHABILITATION This AGREEMENT, made this -Z!5�day of February, 2008 by and between A. J. Wood Construction (hereinafter referred to as the CONTRACTOR), having a business address of P.O. Box 1769, Salem NH and David and Sharon Moulton (hereinafter referred to as the OWNER, residing at 2A Linden Street Unit 1, Salem MA. WITNESS THAT: WHEREAS, the OWNER intends to rehabilitate his/her property located at 2A Linden Street, Unit 1 in Salem, Massachusetts, now therefore, the CONTRACTOR and OWNER, for the consideration herein stated, mutually agree as follows: 1. BID AND PROPOSAL 1.0 This AGREEMENT shall consist of the bid and proposal; the general conditions included herein, drawings (if any) and approved work write-up/specifications. 1.1 All work described and listed in the work write-up/specifications dated November 26, 2007 with Addendum per Walk Through dated January 11, 2008 (attached) shall be performed by the CONTRACTOR for a sum not to exceed $3,500.00. 1.2 Exceeding of the above stated amount shall be grounds for the termination of this AGREEMENT by the OWNER if the CONTRACTOR did not receive prior written approval from both the OWNER and the City of Salem's Department of Planning and Community Development (heretofore called the CITY). Said written approval shall be in the form of an amendment.. 1.3 If the AGREEMENT amount is exceeded without the approval stated heretofore (1.2), the CONTRACTOR would bear all additional costs of the materials purchased and work performed. 1.4 If the AGREEMENT amount is exceeded with the knowledge and prior approval of the OWNER, in collaboration with the CONTRACTOR and without the prior consent of the CITY, then the cost of said improvements would be bom solely by the OWNER. INITIALS: Paee 1 of 8 2. TERM OF AGREEMENT 2.0 The CONTRACTOR shall commence the work to be performed within 14 days of the Notice to Proceed issued by the CITY. 2.1 Said work shall be completed within 30 consecutive days. 2.2 The CONTRACTOR shall provide the OWNER with at least three days notice that work will commence. 2.3 The commencement date may be changed, if agreed upon by both the OWNER and CONTRACTOR. The OWNER must notify the CITY in writing of the change in commencement date. 2.4 Delays caused by, but not limited to, such events as poor weather conditions, illness or unforeseeable construction problems may, at the option of the OWNER and CITY, constitute legitimate reason for delays in the start or continuance of work. In such event, the CONTRACTOR shall notify the OWNER or the CITY of any delay and the reason. The OWNER and CITY reserve the right to reject said reason and demand continuance of work. 2.5 Failure to continue work if reason for delay is rejected, pursuant to 2.4, shall be grounds for termination of this AGREEMENT by the OWNER. 2.6 Delays that are deemed legitimate will not be charged to the term of this AGREEMENT and will be considered an automatic extension of the AGREEMENT. 3. USES AND DISBURSEMENT OF FUNDS 3.0 Project funds will be used only for those activities deemed eligible under Community Development Block Grant (CDBG) Regulations, pursuant to 24 CFR § 570.201 — Eligible activities and/or HOME Program,pursuant to 24 CFR § 92.205. 3.1 The CONTRACTOR may make application for payment only on those items in the approved work write-ups or amendments thereto and satisfactorily completed. Satisfactory completion is determined by the CITY. Payments will be made only by approval of the CITY. 3.2 The CONTRACTOR's application for payment shall include an itemized list of the work completed and copies of receipts and/or paid invoices for materials. The CITY will reject payment requests that are not itemized and/or incomplete. 3.3 In order for payments to be disbursed, proper city building code inspections, heating and plumbing and/or electrical permits must be pulled before the start of work and proper signoffs received for work that is complete. 3.4 Work performed under this AGREEMENT shall be payable within thirty (30) days after the work is satisfactorily completed, approved by the OWNER and the CITY, whose inspection and approval of such work is required, and a complete, itemized invoice is submitted. INITIALS: Page 2 of 8 3.5 Payment by the CITY shall not exceed the percentage of work completed nor the amount of assistance committed by the CITY and/or the OWNER. 3.6 The OWNER and the CONTRACTOR acknowledge that, work not included in the Work Write-up, performed at the homeowner's request is not covered by this contract. This includes not only additional work items but also upgrades in materials and the quality of installation (i.e. ceramic tile instead of linoleum, hardwood floors instead of carpeting, etc.). The quality of product and installation is the sole responsibility of the OWNER and the CONTRACTOR. 4. FINAL PAYMENT 4.0 The CONTRACTOR is allowed to make up to 3 (three) progress payment requests, unless there is a prior AGREEMENT to allow more payments. Final payment shall be requested only upon completion of all work in the approved work write-up and amendments thereto. 4.1 Final payment shall be made only upon receipt from the CONTRACTOR of a CoNTRACTOR's FINAL ANVoICE, RELEASE FOR LIENS AND WARRANTY, SUBCONTRACTOR'S LIST, AND BUILDING PERMIT. 4.2 Once final work is approved by the Housing Programs Inspector, all proper permits have been pulled and required inspections have been completed and signed off by the City of Salem's Building Department, the OWNER and the CONTRACTOR acknowledge that if the owner refuses to sign Certificate of Final Inspection and/or cosign check, the City may proceed to issue final payment to the contractor and the project will be considered complete. 5. RESPONSIBILITIES OF THE OWNER(S) 5.0 The OWNER agrees to comply with the conditions of this section. The CITY reserves the right to withhold payments if the OWNER fails to comply with the section. 5.1 The OWNER shall be current in payments to the CITY of real estate taxes, user fees and other obligations. Failure to be current in payments or to have made agreement to pay delinquent accounts shall be grounds for termination of the project and withdrawal of funds by the CITY, or suspension of the project. 5.2 The OWNER shall permit the CONTRACTOR to use, at no cost, existing bathroom facilities and utilities such as electric power, lights, water and telephone only for the purposes of this AGREEMENT. Failure of the OWNER to cooperate in this way shall be grounds to suspend or terminate the project. 5.3 The OWNER will facilitate work by removal of rugs, coverings and furniture as necessary and when possible. 5.4 The OWNER will, when possible, cooperate with the CONTRACTOR in keeping the project interior and or/exterior clean and free of debris, in compliance with the State Sanitary Code, Article II. iINITIALS: Page 3 of 8 5.5 Any unreasonable action by the OWNER, as defined by the CITY, to hinder the CONTRACTOR from proceeding with work, or any action by the OWNER to deny the CONTRACTOR access to the project site, shall be grounds for suspension or termination of the project by the CITY and Subsequent withdrawal of public funds committed to the project. 5.6 In the event that the OWNER takes legal action against the CONTRACTOR and, thereby, delays the project for more than sixty(60) days, then the CITY reserves the right to suspend the project temporarily and apply project funds elsewhere. Said funds may be restored upon completion of legal action. 6. RESPONSIBILITIES OF CONTRACTOR/PERFORMANCE OF CONTRACT WORK 6.0 The CONTRACTOR agrees to comply with the conditions of this section. The CITY reserves the right to withhold project payments, suspend or terminate the project if the CONTRACTOR fails to comply with the section. Failure by the CONTRACTOR to comply with this section may also be grounds for the CITY to deny the CONTRACTOR or any SUBCONTRACTOR participation in the CITY's housing programs for up to three (3) years. 6.1 The CONTRACTOR shall maintain records of this project for at least three (3) years after its completion and shall provide access to the CITY, upon request, to inspect all records related to the project, including, but not limited to bids, drawings, vouchers, payrolls and purchase orders. 6.2 The CONTRACTOR shall comply with all applicable building, health and fire codes in the conduct of this project and must obtain all necessary required permits for work. Cost of permits may be included in the CONTRACTOR'S bid. Copies of permits must be submitted to the CITY before commencement of work. Copies of signed-off permits must be submitted to the CITY before final payment will be released. 6.3 The CONTRACTOR acknowledges that all lead based paint abatement/deleading will be conducted in accordance with the both the federal and state lead based paint regulations. All contractors conducting lead based paint abatement/deleading must be licensed by the Commonwealth of Massachusetts, Department of Labor and Workforce Development, Division of Occupational Safety. 6.4 The CONTRACTOR shall indemnify and save harmless the OWNER from liability for any personal injury or damage to the property in the performance of work unless there is a reason to believe there is OWNER negligence. n'6.5 Unless otherwise approved, the CONTRACTOR shall carry full and complete Workmen's Compensation Insurance for all employees who require coverage under the law. 6.6 Prior to the start of the project, the CONTRACTOR shall provide the CITY with evidence of liability insurance for not less than $300,000 for bodily injury and $100,000 for property damage, unless otherwise approved. 6.7 The CONTRACTOR shall keep the project premises clean and free of work debris and remove all such debris upon completion of work. Materials and equipment that have legally been removed and replaced as part of the work shall belong to the CONTRACTOR. INITIALS: Pave 4 of 8 6.8 The CONTRACTOR shall not assign this AGREEMENT or any portion of it without written consent of the OWNER and the CITY. 6.9 Abandonment of project work by the CONTRACTOR for more than ten (10) consecutive days without the written or verbal consent of the OWNER and the CITY, shall be deemed a breach of contract and is grounds for termination of this AGREEMENT by the OWNER and the CITY. In the event of such termination, the CONTRACTOR shall be liable to the OWNER or to the CITY any costs beyond the amount of this AGREEMENT, which are incurred for completion of this project. 6.10 If the CONTRACTOR's right to proceed is terminated, the OWNER and/or the CITY may take possession of or utilize any materials, tools, equipment, or plants on the site as may be necessary to complete the project. 6.11 The work specified herein must be completed by the CONTRACTOR within the terms of the AGREEMENT, including extensions. The OWNER and/or the CITY reserves the right to take legal action to recover any payments previously made to the CONTRACTOR. 6.12 During the performance of this contract and during the term of this AGREEMENT, the CONTRACTOR agrees to the following conditions. The CONTRACTOR shall 6.12.1 Not discriminate against any person seeking his/her employment or any employee because of race, color, national origin, gender, age, religion, familial status, sexual orientation or disability. Such action includes, but is not limited to, employment, upgrading, demotion, transfer, recruitment, advertising, layoff, termination, rates of pay or other compensation, and selection for training, including apprenticeship. 6.12.2 post hereinafter, in a conspicuous place, available to employees and applicants for jobs, notices provided by the CITY setting forth this non-discrimination clause. 6.12.3 include all provisions in this section to be placed in any agreement s/he has with subcontractors working on the project. 6.13 The CONTRACTOR and any subcontractor is prohibited from inducing by any means, any persons employed in the construction, completion or repair of public work, to give up any part of the compensation to which s/he is otherwise entitled. The CONTRACTOR shall fully comply with this section, pursuant to 18 USC 874, the Copeland "Anti-Kickback" Act, as supplemented in 29 CFR § 3. The CONTRACTOR shall cause to be inserted in any contracts and subcontracts related to this project such "Anti-Kickback"regulations. 6.14 The CONTRACTOR agrees to abide by Lead Based Paint Poisoning Prevention Act, which prohibits the use of lead-based paint in residential structures constructed or rehabilitated with federal assistance in any form. 7. MISCELLANEOUS f United States and no resident commissioner 7.0 No member of or delegate to the Congress o the U S t shall be admitted to any share or part of this AGREEMENT or derive any benefit from the same, I'I INITIALS: Paee 5 of 8 provided that the foregoing sanction is not construed to this contract and is made with cooperation for its general benefit. 7.1 No Officer, employee or member of the governing body of the CITY or the Department of Planning and Community Development, who exercises or functions or has responsibilities in connection with this project, shall have any private interest, direct or indirect, in the AGREEMENT or in proceeds of this loan or grant. 8. AMENDMENTS AND CHANGE ORDERS 8.0 This AGREEMENT, executed under the regulations of the U.S. Department of Housing and Urban Development and the general laws of the Commonwealth of Massachusetts, may be modified or amended only by a written instrument executed by the OWNER and CONTRACTOR, with the consent of the CITY. 8.0.1 Change orders shall only be executed for unforeseen conditions that require modifications in the work. The written Change order shall itemize the changes. Change Orders that change in the amount of this AGREEMENT, will result in an amendment to the Owner's Mortgage with the City of Salem. 8.0.2 Amendments shall be executed if there is either an increase or a decrease in the amount of the AGREEMENT. The written instrument shall itemize the changes. 8.2 The OWNER and the CITY reserve the right to withhold payment for any work performed, which is not authorized by either this AGREEMENT or amendments thereto. 9. WORK GUARANTEES AND PROTECTIONS 9.0 The CONTRACTOR, in consideration of the final payment s/he received under this AGREEMENT, hereby releases the OWNER and the CITY from any and all claims arising from or by virtue of this AGREEMENT. 9.1 The CONTRACTOR, by execution of this AGREEMENT, hereby provides the OWNER with a guarantee of all work for a period of one (1) calendar year from the date when said work is completed or terminated. This includes work terminated before all work specified under this AGREEMENT is completed. 10. RIGHT OF RESCISSION 10.0 The OWNER and the CONTRACTOR, hereby understands that, under the general laws of the Commonwealth of Massachusetts, the OWNER may cancel this AGREEMENT if it has been consummated by a party thereto at a place other than the address of the seller (CONTRACTOR), which may be his/her main office or branch thereof, provided the seller (CONTRACTOR) is notified in writing at his/her main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following this AGREEMENT. INITIALS: Page 6 of 8 11. INDEMNIFICATION 11.0 The OWNER and the CONTRACTOR shall save harmless the CITY against claims for injuries to persons on the premises of the project or damage to project-related property. 11.1 The OWNER and the CONTRACTOR are required to reimburse the CITY in the event such claim is successfully prosecuted by an injured third party and damages recovered against the CITY. 11.2 The OWNER and the CONTRACTOR shall be required to carry all necessary and required insurances for the work to be provided under this AGREEMENT and for coverage of loss or damage on any premises affected by this AGREEMENT. This shall include, but not be limited to, insurances and certifications for contractors, subcontractors and vendors. 12. LEFT BLANK INTENTIONALLY 13. NOTICE TO PROCEED 13.0 The execution of this AGREEMENT constitutes notice to the CONTRACTOR to proceed with work specified herein, or attached hereto, no sooner than three (3) business days following the date of signing of this AGREEMENT. IN WITNESS THEREOF, the CONTRACTOR and the OWNER (S) have entered into this AGREEMENT as of the date first written above. FOR THE CONTRACTOR FOR THE OWNER(S) By: A. J. Wood Construction By: ILVe'-, � •QY✓'�� Name David Moulton cow Signature M Owner Title haron Moulton Date Date: WITNESS: By: Jennifer Kolodziej Authorized Representative of the Cit of Salem, Massachusetts (rai&e INITIALS: Pace 7 of 8 Attachments 1. Work Write-Up 2. Work Write-Up with Addendum 3. Selected Contractor's Bid Form INITIALS: Pace 8 of 8 I CITY OF SALEM DEPARTMENT OF PLANNING AND COMMUNITY DEVELOPMENT y Y 120 WASHINGTON STREET ♦ SALEM, MASSACHUSETTS 01970 TEL: 978-745-9595 • FAX: 978-740-0404 KIMBERLY DRISCOLL, MAYOR LYNN GOONIN DUNCAN, AICP DIRECTOR HOUSING REHABIUTATtoN LOAN PROGRAM WORK WRITE-UP PROPERTY INFORMATION: Sharon&David Moulton Homeowner (s): Date: November 26, 2007 2A Linden St., Ut Prepared by: Cliff Ageloff _ Case#: Housing & Construction Consultant 1. LICENSE: The contractor must meet all local and State licensing requirements. 2. INSURANCE: Contractor must show proof of adequate liability insurance and workmen's compensation coverage be provided. 3. PERMITS: The contractor must obtain all required building permits prior to starting work. Copies of the required permits must be submitted to the Housing Program. 4. CODE REQUIREMENTS: All workmanship must conform to the Program's guidelines, all applicable Massachusetts Building Code and local codes and must be of acceptable quality, as determined by the Housing Programs Inspector. 5. WORK AREAS: The owner must completely remove all furniture, stored items and other obstructions in the work areas identified herein. Items must be moved to a non-work area and covered by the owner or relocated to temporary storage as needed. Neither the Program nor the Contractor is responsible for owners' items improperly relocated during construction. Work can not proceed unless work areas can be freely accessed by the contractor(s) on a regular basis during the term of the contract. Failure to provide regular and unfettered access to work areas may be cause for contract termination. Contractors are responsible for verification of field conditions measurements and quantities. Submission of a_ bid is presumptive evidence that contractor has evaluated all site conditions which pertain to the work herein. Permits and Permit Fees to be included in all bids. WORK SPECIFICATIONS for REPAIRS 1 Code Compliant Earess Window for sleepina room 1. Remove and dispose wall and window section as needed to accommodate the installation of one new window in the rear room off the kitchen. 2. Include removal of existing window unit and dispose all debris. 3. Provide and install one new Harvey Industries Classic Pro Weld or equal new construction window which complies with CMR 780 and the MA Sanitary Code Section 11 for emergency egress for all sleeping rooms. 4. Contractor is responsible for sizing the window to be installed to yield the acceptable net clear opening requirements specified in the 1 &2 Family Code. 5. Window unit to be white vinyl with double locks and half screen 6. Comply with sill heights and window opening requirements 7. Unit must be Energy Star rated for this region 8. Provide and install all framing as needed to accommodate new window opening 9. Patch and repair to match all existing interior and exterior finishes including siding, sheetrock, paint and all finishes. 10. Provide and install interior and exterior casings to match all adjacent finishes and finish to match existing conditions. An egress window must satisfy all four International Residential Code (IRC)criteria: • Minimum width of opening: 20 in. • Minimum height of opening: 24 in. • Minimum net clear opening: 5.0 sq. ft. for ground Floor • Maximum sill height above floor: 44 in. - • A 20-in. by 24-in. window is not acceptable for egress. 1 CITY OF SALEM A . DEPARTMENT OF PLANNING AND COMMUNIITY DEVELOPMENT RINBERLEY DRISCOLL MAYOR 120 WASI-RNG"iON S"11UiE I♦ SAIEM,V mSAC7IUSEITS 01970 'I'EI.978-619-5685 ♦ F.vr:978-740-0404 L1:NN GOONIN DUNC.w,AICP DIRECTOR HOUSING REHABILITATIONLOAN PROGRAM WORK WRITE-UP WITH ADDENDUM PER 1/11/08 WALK THROUGH PROPERTY INFORMATION: Homeowner (s): David & Sharon Moulton Date: January 11, 2008 2 A Linden Street, Unit I Prepared by: Cliff Ageloff Case #: 08-1 1E Housing & Construction Consultant 1. LICENSE: The contractor must meet all local and State licensing requirements. 2. INSURANCE: Contractor must show proof of adequate liability insurance and workmen's compensation coverage be provided. 3. PERMITS: The contractor must obtain all required building permits prior to starting work. Copies of the required permits must be submitted to the Housing Program. 4. CODE REQUIREMENTS: All workmanship must conform to the Program's guidelines, all applicable Massachusetts Building Code and local codes and must be of acceptable quality, as determined by the Housing Programs Inspector. 5. WORK AREAS: The owner must completely remove all furniture, stored items and other obstructions in the work areas identified herein. Items must be moved to a non-work area and covered by the owner or relocated to temporary storage as needed. Neither the Program nor the Contractor is responsible for owners' items improperly relocated during construction. Work can not proceed unless work areas can be freely accessed by the contractor(s) on a regular basis during the term of the contract. Failure to provide regular and unfettered access to work areas may be cause for contract termination. Contractors are responsible for verification of field conditions measurements and quantities. Submission of a bid is presumptive evidence that contractor has evaluated all site conditions which pertain to the work herein. Permits and Permit Fees to be included in all bids. .�ow•� CITY OF SALEM DEPARTMENT OF PLANNING AND COMMUNITY DEVELOPMENT K INBL RLEY DRISCOLL MAYOR 120 WAS111NGl'ON SIREII'I'♦ SA11M,MA.SSAC 1USL'I S 01970 Tel.:978-619-5685 ♦ FAX:978-740-0404 LYN-N GooNIN DuuGnN,AICP DimcroR WORK SPECIFICATIONS for REPAIRS 1. Code Compliant Egress Window for sleeping room I. Remove and dispose wall and window section as needed to accommodate the installation of one new window in the rear room off the kitchen. 2. Include removal of existing window unit and dispose all debris. 3. Provide and install one new Harvey Industries Classic Pro Weld or equal new construction window which complies with CMR 780 and the MA Sanitary Code Section II for emergency egress for all sleeping rooms. 4. Contractor is responsible for sizing the window to be installed to yield the acceptable net clear opening requirements specified in the 1 & 2 Family Code. 5. Window unit to be white vinyl with double locks and half screen 6. Comply with sill heights and window opening requirements 7. Unit must be Energy Star rated for this region 8. Provide and install all framing as needed to accommodate new window opening 9. Patch and repair to match all existing interior and exterior finishes including siding, sheetrock, paint and all finishes. 10. Provide and install interior and exterior casings to match all adjacent finishes and finish to match existing conditions. An egress window must satisfy all four International Residential Code (IRC) criteria: • Minimum width of opening: 20 in. • Minimum height of opening: 24 in. • Minimum net clear opening: 5.0 sq. ft. for ground floor • Maximum sill height above floor: 44 in. • A 20-in. by 24-in. window is not acceptable for egress. 2. Ceiling Repairs — 2 Bedrooms Approximately 12 X 10 Each 1. Remove and dispose existing acoustical ceilings in both bedrooms and all unstable substrates. 2. Provide and install new sheetrock ceilings made ready for primer and paint. CITY OF SALEM �,.cm'�x4g4 ` DEPARTMENT OF PLANNING AND A ` COMMUMTY DEVELOPMENT K INIBE RLEY DRI SCULL. 120 W:\SI[I,\(;I UN SIRi'6'I' • SALIi.M,MASSAkI it SE'I'IS 01970 NIA)UR 1111-:978-619-;685 ♦ FAx:978-700-0304 LS.NS G,rINi]Dt N(AN,A]CT . DIIuc,'Ir K HOUSING REHABILITATION LOAN PROGRAM BID FORM Property: ?A Linden St.,UI, Salem, Massachusetts WORK ITEM PRIG CODE COMPLIANT EGRESS WINDOW tS U u I. FOR SLEEPING ROOM �—ZI�U O TOTAL BID $ 3 S 0C1 I, the undersigned contractor, have inspected the above listed property and understand the extent and character of the work to be completed as described in the Work Write-Up. The bid includes every item identified in the Work Write-Up by the respective numbers. I propose to furnish all labor, materials, and equipment R�essary to accomplish all work described in the Work Write-Up for the sum of 2Gee sand ✓L llati p-ed Dollars ($ I agree to begin the work within fourteen (7) calendar days of the Notice to Proceed and complete the work within sixty (30) calendar days of the Notice to Proceed. I agree to fully guarantee all labor and materials for one (1) year from the project completion ate. DALWJ Company Name i C Signature of Authorized Representative R (Jr/ a (, 5 Address Title of Authorized Representative (a 3 B Ci LA Ce- (% 1�1 �c 1� e ephone Date