Loading...
HomeMy WebLinkAboutBuilding Permit # 1/31/2017 AORTil BUILDING E IT T F T V APPLICATION FOR PLAN EXAMINATION - : Permit No#: Date ReceivedOATED CH Date Issued: i PORTA,l°d'I': .Applicant must complete all items on this page LOCATION t "... Print PROPERTY OWNER l i Print 100 Year u re ` . MAP PARCEL: � ZONING DISTRICT Historic District Y ct yes es � � ,? Machine Shop Village yes (r oll TYPE OF IMPROVEMENT PROPOSED USE _ _---._--- - - Residentiala _ Non- Residential [I New Building -�. -_ %One family 11 Addition ❑ Two or more family I] Industrial Alteration _ No. of units: m — ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition, I wz".—. "m,..��_._... El Other ° bYi rir,,}rrd DESCRIPTION OF WORK TO DE PERFORMED: - --- Identification- Please Type or Print Clearly OWNER: Name: .,_ . .° Phone: ck Address: Contractor Name: Phone Email,, Address: °. w .. Supervisor's Construction License: O's-31-ups Exp. Date \ 1,q Home Improvement License; �3 Exp. Date; ARCHITECT/ENGINEER ° .. Phone: -,._................... Address: Reg. FEE SCHEDULE:BULGING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Oast: $_ 2,,o., D.0 Q FEE: $ 2--X570 Check o.: Receipt No.: NOTE: Persons cantractanwat unregistered contractors do not have cccess to the guarantyfim rv. ..M P99IG2m ,,,, "A �ri,c iris 9r�Dl�f1P�I ° r '/�e7 2971 i>/✓/i, � '( rfl llJP1'a f/�elliPUl9� ,I e!�O� gratxo rll'f ancc�e f / ,rl/ / $1g ', ._. ..... Pians Subrnitte Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DTSPQSAL Public Sewer ❑ Tanning/Massage/Body A1-4 ❑ SWiminivzgPools ❑ Well Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. Permanent Dpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING DEVELOPMENT Reviewed On Signafiur�� COMMENT'S CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed onSi nature COMMENTS t7 QG Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Wafer& Sewer Connection/Si nature&I]ae Drivewa Permit DPW Town Engineer: Signature: Located 384 Osgoo Street ihIRE.DEPA TMEN T � 1 Temp} Duna steron s�t� es . LOCatECi at 1424 Male t gun Fire Deparfinenf : ��':".,'P%„�"y"r,,�H ��y� ^^'c F:�` "�� .� �t �.�' ��";�a '�'m'�' ,. r'"�'"`����r ✓ �i-.�a'r?��"'^ ��� s�m � d ..es s- c ��sK.avF KI C®MIIlIENTS � � k 5�rx rA3 � ks � . x t4ORTI �9 own of = �. _ ,. ndover 0 .y~ *w No. 16o ,, 2AII z h ver, Mass, Ad. a LAKE 1 COCNICHEWecK ti U BOARD OF HEALTH Food/Kitchen T D Septic System J THIS CERTIFIES THAT PERM .,.. litVIt� *4 �^ ............... BUILDING INSPECTOR has permission to erect., ,. ........ buildings on .. Io..... � ',.. ., ......... Foundation ... . .. .... .... . . . . . . �► Rough t0 be OCCUpled as .. ...... ..... . .,.:.... /�.... ... .... . .... .,.... Chimney provided that the person accepting this permit shall in every respect conform to th terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relatin to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. 14 'aPLUMBING INSPECTOR C3 Rou h VIOLATION of the Zoning or Building Regulations Voids this Permit. g Final PERMIT EXPIRES I MOTHS ELECTRICAL INSPECTOR_ UNLESS I Rough Service .............. ..I .... ......... ..........................,............ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy ermit Required t® Occupy Buildin Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 98 Forest Street Ked T North Andover,MA 01845 9/ PH:978-688-5335 Building Contractor • FAX:978-688-7207 Proposal To: Jack&Nancy Driscoll 110 Forest Street All Home Improvement Caniraclors and Subcontractors engaged in home improvement contracting,unless North Andover, Ma. 01845 specifically exempt from registrallon by Provistons 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,Hone Improvement Contract Registration,One Ashburton Place, From: Kevin Murphy Room 1301,E3oslon,MA02108.(617}7278598 Cis: Date: 1/30/2017 .lob: Add three quarter bath in basement Date of plans: None 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 worts on or about 2/1117. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 3130/17.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 f this Agreement. In the event any defect in workmanship or materials, or following completion and shalt comply with the requirements o 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 aterials or workmanship. The foregoing warranties shall survive any inspection performed in replaced, such damage or such defect in m 9 connection with the agreed-upon work. i it i Section 111 -Scope of Work i i Page 1 of 4 Kevin Murphy Page 2 of 4 Building contractor 98 Forest Street NoMkn over,MA 01845 PH:9786885335 FAX:97B G88-7207 General Proposal is to build hallway and add a three quarter bathroom, in existing unfinished basement area. Permit will be provided by contractor. Building All frame materials will be provided to build hallway and bath area. Walls will be 2x4. Bottom plate will be pressure treated. Plumbing Plumbing required to add three quarter bath with ejector pump, and relocate laundry connections will be provided. Plumbing fixtures to be provided by owner, installed by contractor. Electrical Electrical work required to wire bath to code will be provided. Panasonic fan I light will be supplied and installed. Any surface mounted fixtures(vanity light)to be supplied by owner, installed by contractor. Electric heat will be installed in bathroom. j Insulation i o Walls will be insulated to code, 9 Piaster Walls in bath and hallway will be blue boarded and skim coat plastered. Ceilings will be suspended. s ft Interior Trim/Doors Pre-primed interior trim and doors will be supplied and installed to match existing. Bath vanity to be supplied by owner, installed by contractor. Flooring Floor in bathroom and hallway will be tiled. An allowance of$6 per square foot has been included for bathroom the materials. Tile in hall way to be supplied by owner. Painting No allowance has been made for any painting. 1; Waste Removal Any construction debris will be disposed of by contractor. Devin Murphy Page 4 of 4 Building Contractor 98 Forest Street North Andover,MA 01 B45 PH:978688-5335 FAX:978-88t1-7207 Section IV—Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of ... ... ... ... ... ... ... ... ... ... ... ... .$ 20,800 Payment to be made as follows: Percentage/ltem Description Amount 1 Permit obtained / deposit $1800 2 Framing Complete $5000 3 Plastering complete $8000 4 Trim / the installed $4000 5 Job complete $2000 Total 5 $20,800.00 "Notico:No agreement for Homo improvement contracting work shall require a down payment(advance deposit)of more that one-third of the total contract price of the total amount of all deposits or payments which the contractor must make,in advance,to order ancUor otherwise obtain delivery of special order materials and equipment,whichever is greater Contractor: Kevin Murphy 98 Forest Street No.Andover, MA 01845 Registration No: 101874 Section V—Acceptance Acceptance of Proposal—I have read this document and accept the prices, specifications, and conditions stated. I understand that upon signing,this proposal becomes a binding contract. You are authorized to do the work as specified. 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 DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES I Signature Date 0 3 uh-1 -- Signature Date ot, "e-0 v 77, .................................... g F I� 0 ANt s ' i The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.inass.govldia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH IME PERMITTING AUTHORITY. Applicant InformationPlease Print Legibly Name (Business/Organizafion/Individual): GIf Address: City/State/Zip: �,)v Phone#: `�­t �:J, Are you an employer?Check the appropriate box: Type of project (required): 1.0 1 am aemploycr with V ---=ployccs(full and/or part-time).* 7. 0 New construction 2f]I am a sole proprietor or partrimbip and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.) 9. Q Demolition 3.Ej I am a homeowner doing all work myself.[No workers'comp.insurance required.)t 10 Building addition 4,n 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 sok I I.[]Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.0 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet- 13.0 Roof repairs Tbcse sub-contractorshave employeesand have workers'comp.insurance,1 6.0 We am a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other . ther. 152,§1(4),and we have no employ=.[No workers'comp.insurance"uircd.) Any applicant that checks box it I must also fil I out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. rCootractors that check this box must attached an additional sbcct 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 my employees.. Below is the policy and job site infortnadon. Insurance Company Name: J" Policy M or Self-ins.Lie. -1.1-6 5 o� Expiration Date: A Job Site Address: o City/State/Zip:k/4) AV 1?)1-t 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 up to$250.00 a day against the violator-A copy of this statement may be forwarded to the Off-ice of Investigations of the DIA for insurance coverage verification. I do hereby,certify qnder,the pains and penalties ofperjury that the information provided above is true and correct Si afore tj Date: V-I 0_1 : s...r` Phone ft: qV­', I,-- �,,_�, �, -��­),11Y Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.Cityfl'own Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person:- Phone/h DATE IMMIDD'YYYYI Aca'RD CERTIFICATE OF LIABILITY INSURANCE 12/12/16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE, DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(€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 ctlllfer rights to the certificate holder in lieu ofsuch endorsement(s). CONTACT q PRODUCER NAME: Sandi Munroe — PAX -- - _..._ . M.P. Roberts Insurance Agency PHONE (978) 683-3147 �ALC.LtpEztt); (978) 683=8073 (A!C Na] - 1060 Osgood Street EMAI ADDREL SS: Sandi_@mprobertsinsurance.com North Andover, MA 01845 - - I—NSURRiS.)AFFO_�DIGCO— VERAGE _ AIGl tNSUReRa_Merchants mutual ..Insurance Co..._.._ INSURED INSURERB:Guard Insurance KEVIN MURPHY REMODELING INSURERC;_ _. . - _.. 98 FOREST STREET INSURERD_;_ NORTH ANDOVER, MA 01845 INSIfftER.Ei._- INSURER F 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN5R ADDL SUBR" I POLICY EFF 1 POLICY EXP '.. LIMITS LTR TYPE OP INSURANCE R WVD' POLICY NUMBER MMIDDIYYYY MMIDDIYYYY I 11/22/16. 11/22/].7 EACH OCCURRENCE 3 1,OQO-,000_,.. GENERAL LIABILITY 'BOP1068945 I --- - f �OAAMG£r0 f2>wb7TEq X COMMERCIAL GE NE RAL LIABILITY PREMISES LE .oscuftence] $ 00 x ,000 CLAIMS-MADE I..,X1OCCUR !MED EXP(Arryone person)......-$ _...._ ,0.00._-- IPERSONAL&ADV INJURY $ GENERAL AGGREGATE 3 2,OOO_,.O.00.. GENT AGGREGATE LIMIT APP LIESPER ' PRODUCTS-C.OMPIOPAGG 3 2,000.,000 . X POLICY PRO_ECT LOC COMBINED SINGLEL! iT 3 A AUTOMOBILELIABILI7Y MCA701360fl 1/23/16 1/23/17 _ ....__ 0(Eac0 ,_000..,., _ ANYAOTO E 430MLY INJURY(Par person) ;3 ALLOWN_O SCHEDULED - BODILY INJURY(Per accident) �5 AUTOS X AUTOS NON-OWNED PitOPERTYDAMAGC 5 X HIREDAUT05 X AUTOS i �Peraccidei5ij c 3 A UMBRELLALfAB ODOUR ICUP9145304 11/22/16 11/22/17 FEACHOGCURRENCE S 1,000,000 EXCF�S LIAB CLAIMS-MADE I I 0GGREGATE S 1,000,000 DED RETENTION S Vvl7RKERsCOMPENSATION I 7/1/16 7/1/3.7' }{ WCSTATU- OR..' D KEWC726509 �... TORY.LIMt.T.s.1 ER..' AND EMPLOYERS'LIABILITY Y I N I 1 f ---.--.._._ ... ... .. ANY PROPRIETORIPARTNERILXECUTISIE E.L_EA_G€IACCIpENt,. -...,.,.5--- SOO,_OO.O_ OF FI CERNEMBEREXCLIAE€T7 NIA I r (Mandatory in NH) L.E.L,D3SFASE-EA EMPLOYEE$ --- 500,000---.. II yes describeunder I i t:,L.DISEASE-POLlcvL€MIT I: 500 000 DESCRIPTION OF OPE RATIONS below i l I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 104,Additional Rermrks Schedule,If more spaco is required] CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE D12LIVERED IN TOWN OF NORTH ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER, MA 01845 AUTHORIZED REPRE thkk O 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD dame and logo are registered marks of ACORD Phone: Fax: E-Mail; �fc `iLo-ut�car+!oerr.�ll a�C'l��rJlrtr�/��r/C;- Office of Consumer Affairs&Business Regxulation 45,�W HOME IMPROVEMENT CONTRACTOR Registration 10187.4 Type: 5 / 1=xpiration 6f2912018 Individual KEVIN MURPHY Kevin Murphy 98 FOREST ST. N.ANDOVER, MA 01845 - = Undersecretary Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-053099 Construction Supervisor KEVIN W MURPHY.- 98 FOREST ST s NORTH ANDOvER M E ,w }C1457. CA, Expiration: Commissioner ©612912017