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HomeMy WebLinkAboutBuilding Permit # 2/23/2016 OORTH, BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ' Permit No#: Date Received �RArED PV ,�C9 Date Issued: 212,`Lzj�V) US IM OIiTANT:Applicant must complete all items on this page L`OCA, I ON PFt�OPERTY OWNER �„ � rnt r ,i ,, „�, „� P i 1 0 Y ' St t MAP_� PARCE0ZO( ING DISTRICTHistorc District yes �o Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED SE Residential Non- Residential _ 0 New Building One family ❑Addition ❑ Two or more family 0 Industrial Ilteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition 0 Other ❑ Septic '❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ater/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: ° _f , . Phone: 4L . a -1 Address: v _ ._*.. .. _ � .. . CQrtractar dame; , „ . Phone: Address Supervisor's Construction Licensed 16 Home Irnprovemont;Licen/ xp Date: ARCHITECT/ENGINEER a. Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ ...o O FEE: $ Check No.: Receipt No.: C NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fugd Signature of A ent/Owner g g � � �,� � �'� , )-Signature of contractor 'Town oftAoRTH 2 Andover 0 ., 0 . L tE No. 2AI� A 07. A9460_1"16 C, 0 4- �.K. 11 VAI'' aSSy COCHICMl WICK �.�5 RgTE® ,.P .�9 PU BOARD OF HEALTH Food/Kitchen ERM T �T LD Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ................... .. . ......................... ..... .....................................................®. Foundation has permission to erect .......................... buildings on ... ....®....L&o..o&44&*At...................... Rough to be occupied as ....... _ ....... .. .. . ... ....... .... ... . .. .ry........laftAe..................................... 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 T S ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service .............. ... . ................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final - No Lathingor Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. 0 098 Forest Street Kevin Mi.irphy 0 North Andover,MA 01845 0 PH:978-688-6335 Building Contractor ® FAX:978-688-7207 rropoSal To: Bob Mongell 117 Lancaster Road All Home improvement Contractors and Subcontractors engaged in home improvement contracting,unless North Andover, Ma. 01845 specifically exempt from registration by Provisions of Chapter 142A of the general laws,must be registered with the Commonwealth of Massachusetts.Inquiries about registration and Status should be made to the Director,Home Improvement Contract Registration,One Ashburton Place, From: Kevin Murphy Room 1301,Boston,MA 0210&(617Y727 8598 CC: Date: 2/22/2016 Job: Master bathroom Date of plans: 12/15 Architect: None Location: Same Section I—Work Schedule Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specified here in writing contractor will begin work on or about 2/23/16. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 4/30/16.The owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall no be considered as violations of this agreement. Section 11 —Warranty The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of 1 year following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup,the Contractor shall, at his own expense,forthwith remedy, repair correct, replace,or cause to be remedied, repaired,or replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Section III—Scope of Work Page 1 of 4 � � � I(evin Muj.,plky Page of � umhuomuontlmha � 98 Forest Street North Andover,MA mwp PH:978-688-5335 FAX:978-688-7207 � General � Proposal is to renovate existing master bathroom. Permits will be obtained by contractor. OanmmNUmn Existing shower area and ceiling will be completely gutted. Other walls will be gutted as required. Tile floor will � be removed. Carpets inmaster bedroom and spare bedroom will baremoved. Building All framing materials required relocate shower wall /renovate bathroom will be provided. Plumbing Plumbing required to renovate bathroom will be provided. Fixtures to be supplied by mwner, installed by contractor. Fixtures boremain in same locations. Electrical Electrical work required to renovate bathroom will be provided. Ponamonima fon / light will be supplied and installed. Five inch naoeaaed lights will be supplied and installed. Surface mounted fixtures to be supplied by owner, installed by contractor. General layout to be approved by owner prior to rough. Heating/Air Conditioning Existing heating/air conditioning to remain. New enclosures/grilles will be supplied/installed as required. Insulation Any insulation required,will besupplied/installed hocode. Plaster Bathroom will beb|ueboardedand ahimcoatplastered. Walls and ceiling will besmooth. |nteriorTrimm/Do#rm Any interior trim will be supplied and installed to match existing. Bath vanity to be supplied/installed by others. Painting � � Interior painting for bathroom, and master bedroom will be provided. One coat of primer, and two coats of finish will beapplied toall painted surfaces. Flooring Tile floor and shower will be installed in bathroom.Tile material will be provided by owner. Hardwood floor will be provided in master bedroom and spare bedroom. Floor will be oupp|ied, instoUed, and finished with three coats ofoil based urethane, tomatch existing. Kewiii Nfi�u,ur°pfky Page3 of 4 Budding g Contractor, 98 Forest Street North Andover,MA 01845 PH:978,68&5335 FAX 978-6887207 Waste Removal All demolition/construction debris will be disposed of by contractor. Other Allowances An allowance of$2000 has been included to supply and install glass shower enclosure. Page 4 of 4 8*1111disag Contractor 98 Fol est Street North Anclover,MA 01845 PH'.978-588-5335 FAX:978,688-7207 Section 1 rice Schedule We hereby propose to furnish material and labor—complete $ 39,500 39 500 in Accordance with above specifications fort e sum o ... ... ... ... ... ... ... ... ... ... ... .... .. ... ... .. Payment to be made as follows:. Amount Percenta e/item Description $2500 1 Permit obtained / deposit $5000 2 Demolition complete $10,000 3 Plastering complete $6000 4 Tile complete $5000 5 Painting complete $6000 6 Hardwood floors cam late $5000 7 Jab 100% cam late $39,500-00 Total 7 "Notes:No agreement for Home improvement contracting work shall require a dorm payment(advance deposit)of more that are-third of the total contract price of the total amount of all deposits a payments which the retractor must make,in advance,to order ardor otherwise obtain delivery of special order materials and equipment,whichever is greater [Registration tractor: Kevin Murphy 98 Forest street No.Andover, MA 01845 No: 101874 Section V—Acceptance fications Acceptance Proposal—I have read this document becomes ornd accept the prices,a binding contract.You are author zed#o do h)eI work specified. understand that ooat upon signing,this proposal Payment will be made as outlined above. You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction cancellation must be done in writing Da NOT SIGN THIS CONTRACT IF THERE ARE ANY FLANK SPACES a ` .2v/ Signature � d`�. ®ate�- '" ,- signatu Date The Commonwealth of Massachusetts Department ofIndusirialAccidents I Congress Street,Suite 100 Boston,MA 02114-2017 wtownass.govIdia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FELE D NVITH THE PE RAMITTING AUTHORITY. Aulicant Information rt Please Print Ledbl Name (Business/Organization/Individual): Address:---"\'6 t City/State/Zip: 1-4, Phone#: S 3 7 ArcYVu an employer?Cheek(licappropriate box: Type of project(required): L[n I am a employer-with,--k—employees(full and/or part-time).4: 7, F]New construction IF]I alli a sole proprietor OF partnership and have no employees working forme in 8_ Remodeling any capacity.[No workers'comp.insurance required.] 9. MDemolition, In I arr,a homeowner doing all work myself.[No workers'comp,insurance required]f 10 F]Building addition 4.FJ I-am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance,or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.n I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13,❑Roof repairs These sub-contractors have employees and have workers'comp.insurance,T 14. Other 6.Q We are a corporation and its officers have exercised their right ofexemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box 91 must also fill out the section below showing theirworkers'compensation policy information. i Homeowners who submit this affidavit indicating they are doing all work and thea hire outside contractors must submit a new affidavit indicating such. fContiactors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for nzy employees. Below is the policy and job site information. Insurance Company co Policy#or Self-ins.Lic,If: 01 Expiration Date: Sob Site Address: 1.V') City/State/Zip: PJt, V-0 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of tip to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do her b.v cert �X_y under the ares andpenalfies of1mijivy that the information provid1. ed above is true and correct. Signature: Date Da Phone 9: Official use only. Do not write in this area,to be completed by city or tolvil official. City or Town: Permit/License Issuing Authority(circle one), i 1.Board of Health 2.Building Department 3.City/ToNyn Clerlc 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 4: E1I ED P.V[XVYYYY)A K6D R7W CFRTIFICATF OF LIABILITY INSURANCE 1/2015 THIS CERTIFICATE IS ISSUED ASA 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 REPRESENTATIVEOR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:If the certificateholder is an ADDITIONAUNSURED,the policy(les)must be endorsed.If SUBROGATIOMS WAIVED,subject to the terms andconditionsof the pol icyFertain policiesmayrequirean endorsement.A statementon this certificatedoes not conferrights to the certiflcateholder In lieu of such endorsement(s). CONTA „g PRODUCER NAME CT Sandi Munro ',,.. M P ROBERTS INS AGCY INC PHONE 1978)683-8073(970)603--8073 AX,Nn: (9°78)683••311"7 1,060 Osgood Street E-11 Ss: Banda.@mprobe r sinwsur n .com North Andover, MA 01095 INSURER(S)AFFORDING COVERAGE NAICN INSURERA: MERCHANTS INSURANCE INSURED /('y"]p�VIN MURPHY BUILDING & 40DELING INSURER B: GUARDINSURANCE 9r7 FOREST wS'S STREET INSURERC: NORTH ANDOVER, MA 01.845 INSURERD: INSURER E INSURERF: '.. COVERAGES CERTIFICATE NUMBER: 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, EXCWSIONSANDCONDITIONS OF SUCHPOUCIES.LIMITS SHOWNMAY HAVEBEENREDUCED BYPAID CLAIMS. TYPE OF INSURANCE a POLICY NUMBERPOLICY EEE POLICY EXP '.. MhV22M YY MM47D/YYYY LIMITS �a I... COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ 1 (�(�0 0{ry n,0 MME 1 Z3 RENTF15 —11—E } OCCUR PREMISES Ea orurrence $ 500,000 '...,,,.. AYg4a �y MEDEXP(Anyonapersen) $ 15,000 ''......... (, IV609 5 .1/22/15 11/22/16 PERSONAL&ADV INJURY $ 2,000,000 yy INCLUDED��, ^� /y/^a GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 r r0 p0 p0,�0�0 r0 POLICY -CT LOG PRODUCTS-COMP/OPAGG $ 2,004,444 [q ED OTHER: '.... AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea aeddant ANYAUTO qq y�yp r��y / / / BODILYINJURY(Perperson) $ ALL OWNED SCHEDULED MCA7013608 413608 01/23/15 01/23/16 16 A BODILY INJURY(Per accident) $ AUTOS AUTOS NON�OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1,000,000 ".....''. El A EXCESS LIAR CLAIMS-hADE AGGREGATE $ 1,000,000 CT.7k?9145304 11/22/.1.7 11/22/16 DED I I RETENTION $ $ WORKERS COMPENSATION STATUTE ER AND EMPLOYERS LIABILITY rwra sno'e+,varve I g E.L.EACH ACCIDENT u $ 500,000 tMandatorl7n N N) 1 EC.633(,:."k% 07/01/15 15 07/01/16 E.L DISEASE-EA EMPLOYEE $ 500,000 If yes,desenhe under ( ( ( (�" DESCRIPTION OFOPF.RATIONS belm E.L DISEASE-POLICY LIMIT $ , DESCRIPTION OF'OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Addidona1 Remarks Scl>edule,may b—ttsched if moo,space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL-LED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF NORTH ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01.045 AUTHORIZED REPRESENTA IVE ©1986-2014 ACORD CORPORATION. All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD ¢ Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-053099 Construction Supervisor KEVIN W MURPHY` 98 FOREST ST NORTH ANDOVE'R M' 1 ,r "0 Expiration: Commissioner 06/29/2017 1 � ��e�poa�r��aoazme�c�t�.a�p/�j�utaac�aaeC� I Office of Consumer Affairs&Busibess Reguia'tion OME IMPROVEMENT CONTRACTOR egistration: 101874 Type: Wpir xation: 6/2912016 Individual KEVIN MURPHY j Kevin Murphy f 98 FOREST ST. N.ANDOVER, MA 01845 4 p Undersecretary i P r