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Home My WebLink AboutBuilding Permit #786-16 - 100 CAMPBELL ROAD 1/6/2016 nn nn IAORYH BUILDING PERMIT °�<iL�D.'b 6 / TOWN OF NORTH ANDOVER .. ,� APPLICATION FOR PLAN EXAMINATION ^ Date Received 7RADRA7ED I'Qp4`� Permit No#: acHus�c Date Issued: OI TANT:Applicant must complete all items on this page LOCATION 1 �a r r"n� ►` Print PROPERTY OWNER I C'h and L 01 A 0� Print 100 Year Structure yes no 'QD MAP &L-4ARCEL: ZONING DISTRICT: Historic District yes o Machine Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Resid ntial Non- Residential ❑ New Building sebne family El Addition ❑Two or more family El Industrial El Alteration No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ®Well ® Floodplain U1/etlands ®; 1Natershed 17istri,ct 1Nater/Sewer DESCRIPTION OF WORK TO BE PERFORMED• ' f ► P �-1 o f l�P fi rr��11 an-an tul N I ` l dentication- Pleas Type or Print Clearly RI OWNER: Name: is 1 LaU IF I ��hr� '� Phone: C1 1� to —77 Address: l [Home actor Name- p Phone: 1S o� : ---- ss: LO visor's Construction License: ('S�® �3�q Exp. Date: �, / r`-S 1 Improvement License: Exp. Date: 706 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST B E ON$925.00 ER S.F. Total Project Cost' $ F G ,5( FEE: $ Check No.: Receipt No.: NOTE: Pers ' contr ct' g with unregistered contractors do not have access tot e rga anty fund Location 1190 No.XtP -zo I Date l zo / . - TOWN OF NORTH ANDOVER . Certificate of Occupancy $ Building/Frame Permit Fee $ �y— Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# U Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Private(septic t ❑ Food Packaging/Sales ❑ tank etc. Permanent Dmnpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING cis DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: 1 Comments Conservation Decision: Comments Water& Sewer Connection/sr' nature� ®ate Driveway Permit DPW Town Engineer: Signature: D �: MEN? 1;p •D Locate 8 d S RE4 os ,Fl EPART rrnp . umpster on site , es .;3 goon Street D, � � of 12',T in;Street y r r • �. Y .9. "`� s.,.'.�d aI"'rr { .� t ti Mr .aa r 4 p menttisignature/date _ r u .!"(•':I't ` 7 . Do' COMM E N poc:Suildingl'ermitRevised2014- t Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, waist or service drop requires approval of � Electrical Inspector Yes N® C DANGER ZONE LITERATURE: Yes No MGI,Chapter 166 Section 21A—F and G min.$100-$1000 fine I NOTES and DATA— (For department use) I i Notified for pickup Call Email Date Time Contact Name Doc.Buildinb Pennit Revised 2014 — V I Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract 45 Floor Plan Or Proposed Interior Work 4. Engineering Affidavits for Engineered products ®TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks Building Permit Application Certified Surveyed Plot Plan 4. Workers Comp Affidavit 4. Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction.(Single and Two Family) Building Permit Application aCertified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code 4- Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 36,975.00 m $ - $ 443.70 Plumbing Fee $ 55.46 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 55.46 Total fees collected $ 654.63 100 Campbell Road 786-16 on 1/6/2016 Removal of wet insulation and Reinsulate i NORTF� EA . .c . - ve: : . Lo .... � oh , ver, Mass, COCHICHRWIC« 4ATE0 /.Pa�,�9 V BOARD OF HEALTH Food/Kitchen Septic System PER IT T LD THIS CERTIFIES THAT ............ . rA j".. .. .......LBUILDING INSPECTOR Foundation has permission to er t .......................... buildin on1 ....... ...... : .. ... ....... ....... Rough to be occupied as . ...... .. .�. ....*! �►.......... .... .................................................... Chimney provided that the person accepting this permit shall in every resp conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MOTS ELECTRICAL INSPECTOR UNLESS CONSTRUC TS Rough Service .......... . ...... ........ r.re....................................... 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 Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. William McKay Construction 18 Academy Avenue Bradford, MA 01835 Phone: (978)361-6402 Email:wmc3cons@msn.com Find us on Facebook! PROPOSAL 12/28/15 Project name: Lori& Rich Shorter 100 Campbell Rd. North Andover, MA 01845 Scope of Work:Repair Water Damage • All of the following prices are to repair all areas affected by water damage from the past winter. Damage was too extensive and demolition could not be done by WMC.ServPro has already quoted for the removal of all affected areas, in order to limit any spreading of mold spores or create any harmful or toxic air in existing residence.WMC is only quoting for the repairs after the above mentioned work is completed. • All of the ceilings in the existing residence are textured.This type of textured ceiling cannot be matched. In order to save money and time on this project, any ceiling that is not completely removed will be patched at affected area with %"sheetrock that will be applied over the entire area.Any wall touched by the affected ceiling area will need to be repainted because of this dynamic. • A dumpster will be placed on site and daily cleanup of all debris will be cleaned and disposed of to this dumpster by WMC. • Realizing the Shorter family will be occupying the residence while work is being performed,all work will be scheduled with the customer.Work will be completed in phases to cause the least intrusion on the Shorter family.There will be times that rooms will be under construction and unusable.WMC will work as quickly as possible and schedule as tightly as possible in order to affectively complete all phases. • Relocation and Protection of all household items is included. • Permit fees are included. • Dumpster fees are included. Garage • Insulate garage. • Replacing existing insulation with the same R-value(R-15 in walls and R-21 in ceiling). • If more of an R-value is required by inspector this will result in an extra cost. • Replace sheetrock and plaster in entire garage. Materials:$694.00 Labor:$3,700.00 Total:$4,394.00 Bath Basement Ceiling • Replace insulation removed by ServPro in wall and floor above. • Replace sheetrock on walls only. • Plaster walls affected. • Replace drop ceiling 8'x6'grids and the(material included). Materials: $250.00 Labor:$628.00 Total:$878.00 Storage Room under Porch • Replace insulation in walls and ceiling. • Replace sheetrock on walls only. • Room was unfinished so mud and tape, plaster, paint or flooring is not included in this cost. Materials: $416.00 Labor:$942.00 Total:$1,358.00 Basement Ceiling I • Stain kill and paint ceiling with two coats of standard ceiling white. Materials: $300.00 Labor:$628.00 Total:$928.00 Boys Bedroom • Replace wet insulation removed by ServPro in ceiling and wall. • Paneling cannot be matched so sheetrock and mud and tape will be applied to walls. • Ceiling tiles may be able to be able to be matched. Price is assuming they can be.Also price is for reusing ceiling grid.ServPro must save. • Paint all affected areas in this space. Materials: $325.00 Labor:$942.00 Total:$1,267.00 Office • Remove ceiling in office. • Remove sheetrock and replace with new and install. • Install insulation. • Mud and tape and paint. Materials:$219.00 Labor:$2,676.00 Total:$2,895.00 Girls Bedroom • Patch ceiling insulation removed and wall insulation. • Patch sheetrock removed by ServPro on ceiling and walls. • Apply%" sheetrock over entire ceiling. • Apply new plaster on entire ceiling and walls affected. • Re-Apply any window trim or baseboard affected. • Paint entire room,walls and ceiling. Materials: $ 1,955.00 Labor:$ 1,256.00 Total:$3,211.00 Living Room • Replace ceiling and wall insulation removed by ServPro . • Patch drywall removed by ServPro. • Apply%" sheetrock throughout entire area that is not divided by doorways. • Cannot match plaster finish so entire ceiling will need to be done. • Remove and replace any lights. • Plaster entire area. In this process,wall will be affected so entire room ceiling and walls will need to be repainted. • Paint ceiling and walls. • Replace trim. Materials:$ 1,876.00 Labor:$ 1,784.00 Total:$3,360.00 Porch • Remove laminate flooring and replace 12x16area. Materials:$301.00 Labor:$595.00 Total:$895.00 Back Porch exterior • Disconnect existing deck and stairs. • Lean deck forward and support temporarily in order to allow room to strip entire side wall of siding,sheathing,corner boards and trim. • Replace all insulation on exterior wall. • Replace all exterior sheathing on wall, using ziply and seam tape.This is a sealed sheathing with taped seams. • Reattach existing saved deck on new and proper flashing behind and above ledger board. • Apply new siding,trim and all flashings required.Siding will be hard cement siding because Masonite is no longer available. • Install all trim and decking necessary to match existing. • Paint exterior wall affected to closely match existing house. Materials:$375.00 Labor:$5,634.00 Total:$6,009.00 ServPro clean up Quote(attached)-$6779.51 Dumpster-$ 1,750 Permit-$500 General conditions-$2,750.00 Total: 36,97 .51 cKay Cons ruction LLC ALaurdr Rich Shorter �J II Sempro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 Client: Shorter,Richard&Lori Home: (978)833-8401 Property: 100 Campbell Road N.Andover,MA 01845 Operator: BWHITE Estimator: White,Brian Business: (978)688-2242 x 13 Business: PO Box 328 E-mail: bwhite@servprooflawrence. Lawrence,MA 01842 com Type of Estimate: Weight of Ice&Snow Date Entered: 8/26/2015 Date Assigned: Price List: MAEM8X_AUG15 Labor Efficiency: Restoration/Service/Remodel Estimate: 2015-08-26-1109(1) i Sempro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 2015-08-26-1109(1) Main Level I Living/Dining Room Height:8' 1 a 470.78 SF Walls 385.06 SF Ceiling g/Dining Roo 855.84 SF Walls&Ceiling 385.06 SF Floor N N 1 a 42.78 SY Flooring 59.42 LF Floor Perimeter gq5'io",a•9" 81.00 LF Ceil.Perimeter Porch Door 5'10"X 6'8" Opens into PORCH Missing Wall-Goes to Floor 15'9"X 6'8" Opens into Exterior Window 8'4"X 4' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 1. Tear out wet drywall,cleanup,bag for disposal 216.27 SF 0.80 2.57 175.59 (0.00) 175.59 2. Tear out and bag wet insulation 216.27 SF 0.63 0.95 137.20 (0.00) 137.20 3. Clean floor or roof joist system 96.27 SF 0.75 0.12 72.32 (0.00) 72.32 4. Clean stud wall 120.00 SF 0.60 0.15 72.15 (0.00) 72.15 5. Clean floor 385.06 SF 0.34 0.24 131.16 (0.00) 131.16 6. Apply plant-based anti-microbial agent 216.27 SF 0.22 0.54 48.12 (0.00) 48.12 7. Content Manipulation charge-per hour 1.00 HR 34.78 0.00 34.78 (0.00) 34.78 8. Protect-Cover with plastic 100.00 SF 0.31 0.69 31.69 (0.00) 31.69 Totals: Living/Dining Room 5.26 703.01 0.00 703.01 2015-08-26-1109(1) 12/23/2015 Page:2 Servpro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 Porch Height:8' 4�8-, 5'10"-s-4'9" T = r 1 284.44 SF Walls 183.00 SF Ceiling T r i 467.44 SF Walls&Ceiling 183.00 SF Floor Porch�I _ ; 1 20.33 SY Flooring 46.17 LF Floor Perimeter 54.50 LF Ceil.Perimeter .-10'll"- -S.6 A_ 1"-.-5'6 Window Y X 4' Opens into Exterior Window 3'X 4' Opens into Exterior Window 3'X 4' Opens into Exterior Window Y X 4' Opens into Exterior Window 3'X 4' Opens into Exterior Door 21610 X 61811 Opens into Exterior Window Y X 4' Opens into Exterior Window 3'X 4' Opens into Exterior Window Y X 4' Opens into Exterior Door 5' 10"X 618" Opens into LIVING_DININ DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 9. Tear out wet drywall,cleanup,bag for disposal 100.00 SF 0.80 1.19 81.19 (0.00) 81.19 10. Tear out and bag wet insulation 100.00 SF 0.63 0.44 63.44 (0.00) 63.44 11. Clean stud wall 100.00 SF 0.60 013 60.13 (0.00) 60.13 12. Clean floor 183.00 SF 0.34 0.11 62.33 (0.00) 62.33 13. Apply plant-based anti-microbial agent 100.00 SF 0.22 0.25 22.25 (0.00) 22.25 14. Content Manipulation charge-per hour 1.00 HR 34.78 0.00 34.78 (0.00) 34.78 15. Protect-Cover with plastic 100.00 SF 0.31 0.69 31.69 (0.00) 31.69 16. Tear out non-salv floating floor&bag for disposal 183.00 SF 1.45 1.03 266.38 (0.00) 266.38 Totals: Porch 3.84 622.19 0.00 622.19 l .3'1"-3'-3'3"+ Sewing Height:81 280.67 SF Walls 92.75 SF Ceiling Sewing o 373.42 SF Walls&Ceiling 92.75 SF Floor 10.31 SY Flooring 36.17 LF Floor Perimeter 38.67 LF Ceil.Perimeter Door 2'6"X 6'8" Opens into Exterior Window Y X 4' Opens into Exterior 2015-08-26-1109(1) 12/23/2015 Page:3 Sempro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 17. Tear out wet drywall,cleanup,bag for disposal 116.38 SF 0.80 1.38 94.48 (0.00) 94.48 18. Tear out and bag wet insulation 116.38 SF 0.63 0.51 73.83 (0.00) 73.83 19. Clean floor or roof joist system 46.38 SF 0.75 0.06 34.85 (0.00) 34.85 20. Clean stud wall 70.00 SF 0.60 0.09 42.09 (0.00) 42.09 21. Clean floor 1 92.75 SF 0.34 0.06 31.60 (0.00) 31.60 22. Apply plant-based anti-microbial agent 116.38 SF 0.22 0.29 25.89 (0.00) 25.89 23. Content Manipulation charge-per hour 1.00 HR 34.78 0.00 34.78 (0.00) 34.78 24. Protect-Cover with plastic 100.00 SF 0.31 0.69 31.69 (0.00) 31.69 Totals: Sewing 3.08 369.21 0.00 369.21 Bed Closet Height:8' r 77.11 SF Walls 8.00 SF Ceiling 85.11 SF Walls&Ceiling 8.00 SF Floor Closet 0.89 SY Flooring 9.17 LF Floor Perimeter 12.00 LF Ceil.Perimeter n Door 2'10"X 6'8" Opens into GIRLS BEDRO DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 25. Tear out wet drywall,cleanup,bag for disposal 46.56 SF 0.80 0.55 37.80 (0.00) 37.80 26. Tear out and bag wet insulation 46.56 SF 0.63 0.20 29.53 (0.00) 29.53 27. Clean floor or roof joist system 8.00 SF 0.75 0.01 6.01 (0.00) 6.01 28. Clean stud wall 38.56 SF 0.60 0.05 23.19 (0.00) 23.19 29. Clean floor 8.00 SF 0.34 0.01 2.73 (0.00) 2.73 30. Apply plant-based anti-microbial agent 46.56 SF 0.22 0.12 10.36 (0.00) 10.36 31. Content Manipulation charge-per hour 0.25 HR 34.78 0.00 8.70 (0.00) 8.70 Totals: Bed Closet 0.94 118.32 0.00 118.32 2015-08-26-1109(1) 12/23/2015 Page:4 _ 1 Servpro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 .3'8"-3'-4.3*6"+r Girl's bedroom Height:8' 6"4 Bc Closet } 337.78 SF Walls 124.74 SF Ceiling 1cu''Sbea� } 462.51 SF Walls&Ceiling 124.74 SF Floor a = 1 ` '-63"a 1 13.86 SY Flooring 44.33 LF Floor Perimeter ' 63"-�� 49.67 LF Ceil.Perimeter Door 2'10"X 61811 Opens into BED-CLOSET Window Y X 4' Opens into Exterior Window Y X 4' Opens into Exterior Door 29691 X 61811 Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 32. Tear out wet drywall,cleanup,bag for disposal 142.37 SF 0.80 1.69 115.59 (0.00) 115.59 33. Tear out and bag wet insulation 142.37 SF 0.63 0.62 90.31 (0.00) 90.31 34. Clean floor or roof joist system 62.37 SF 0.75 0.08 46.86 (0.00) 46.86 35. Clean stud wall 80.00 SF 0.60 0.10 48.10 (0.00) 48.10 36. Clean floor 124.74 SF 0.34 0.08 42.49 (0.00) 42.49 37. Apply plant-based anti-microbial agent 142.37 SF 0.22 0.36 31.68 (0.00) 31.68 38. Content Manipulation charge-per hour 1.00 HR 34.78 0.00 34.78 (0.00) 34.78 39. Protect-Cover with plastic 100.00 SF 0.31 0.69 31.69 (0.00) 31.69 Totals: Girl's bedroom 3.62 441.50 0.00 441.50 -2'1--9'3"-4 9" T9 Garage Height:8' j 510.58 SF Walls 325.00 SF Ceiling - e 835.58 SF Walls&Ceiling 325.00 SF Floor 36.11 SY Flooring 65.25 LF Floor Perimeter � r^^ I 77.00 LF Ceil.Perimeter 1._8'2'y 2'6-6„1 Window Y X 4' Opens into Exterior Window 3'X 4' Opens into Exterior Door 2'611 X 6'8" Opens into Exterior Door 99391 X 7' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 40. Tear out wet drywall,cleanup,bag for disposal 580.29 SF 0.80 6.89 471.12 (0.00) 471.12 41. Tear out and bag wet insulation 580.29 SF 0.63 2.54 368.12 (0.00) 368.12 42. Clean floor or roof joist system 325.00 SF 0.75 0.41 244.16 (0.00) 244.16 43. Clean stud wall 255.29 SF 0.60 0.32 153.49 (0.00) 153.49 2015-08-26-1109(1) 12/23/2015 Page: 5 Sempro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 CONTINUED-Garage DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 44. Clean floor-Heavy 325.00 SF 0.49 0.20 159.45 (0.00) 159.45 45. Apply plant-based anti-microbial agent 580.29 SF 0.22 1.45 129.11 (0.00) 129.11 46. Content Manipulation charge-per hour 2.00 HR 34.78 0.00 69.56 (0.00) 69.56 47. Protect-Cover with plastic 200.00 SF 0.31 1.38 63.38 (0.00) 63.38 Totals: Garage 13.19 1,658.39 0.00 1,65839 '--11''6" Boys bedroom Height:8 i376.67 SF Walls 138.83 SF Ceiling Boys 1 edroom = 515.49 SF Walls&Ceiling 138.83 SF Floor 15.43 SY Flooring 46.67 LF Floor Perimeter 1 ' 6 49.17 LF Ceil,Perimeter 6 Door 2'6"X 6'8" Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 48. Tear out wet paneling,bag for disposal 40.00 SF 0.59 0.28 23.88 (0.00) 23.88 49. Tear out and bag wet insulation 46.00 SF 0.63 0.18 25.38 (0.00) 25.38 50. Clean stud wall 40.00 SF 0.60 0.05 24.05 (0.00) 24.05 51. Apply plant-based anti-microbial agent 40.00 SF 0.22 0.10 8.90 (0.00) 8.90 52. Clean floor 138.83 SF 0.34 0.09 47.29 (0.00) 47.29 Totals: Boys bedroom 0.70 129.50 0.00 129.50 Bathroom Height:8' 1 8 j 222.67 SF Walls 47.33 SF Ceiling Bathroom N 270.00 SF Walls&-Ceiling 47.33 SF Floor I I 5.26 SY Flooring 27.83 LF Floor Perimeter 1 I8,81. 1 27.83 LF Ceil.Perimeter DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 2015-08-26-1109(1) 12/23/2015 Page: 6 Servpro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 ,office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 CONTINUED-Bathroom DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 53. Tear out and bag wet insulation 61.83 SF 0.63 0.27 39.22 (0.00) 39.22 54. Tear out wet drywall,cleanup,bag for disposal 50.00 SF 0.80 0.59 40.59 (0.00) 40.59 55. Apply plant-based anti-microbial agent 50.00 SF 0.22 0.13 11.13 (0.00) 11.13 56. Clean floor 47.33 SF 0.34 0.03 16.12 (0.00) 16.12 57. Remove Suspended ceiling grid-2'x 2' 12.00 SF 0.18 0.00 2.16 (0.00) 2.16 58. Remove Suspended ceiling grid-2'x 2' 12.00 SF 0.18 0.00 2.16 (0.00) 2.16 Totals: Bathroom 1.02 111.38 0.00 111.38 2.3^2'6^1--7'„^�* Storage beneath porch Height:8' d _ 17 "' 298.67 SF Walls 144.00 SF Ceiling towge benea442.67 SF Walls&Ceiling 144.00 SF Floor 16.00 SY Flooring 37.00 LF Floor Perimeter 48.00 LF Ceil.Perimeter Door 2'6"X 6'8" Opens into Exterior Window 3'X 4' Opens into Exterior Door 6'X 69819 Opens into Exterior Door 2'6"X 61811 Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 59. Tear out wet drywall,cleanup,bag for disposal 149.33 SF 0.80 1.77 121.23 (0.00) 121.23 60. Tear out and bag wet insulation 293.33 SF 0.63 1.28 186.08 (0.00) 186.08 61. Clean floor or roof joist system 144.00 SF 0.75 0.18 108.18 (0.00) 108.18 62. Clean stud wall 149.33 SF 0.60 0.19 89.79 (0.00) 89.79 63. Clean part of the walls 149.33 SF 0.28 0.09 41.90 (0.00) 41.90 64. Seal part of the walls w/anti-microbial coating-one 293.33 SF 1.27 12.83 385.36 (0.00) 385.36 coat 65. Apply plant-based anti-microbial agent 586.67 SF 0.22 1.47 130.54 (0.00) 130.54 66. Clean floor-Heavy 144.00 SF 0.49 0.09 70.65 (0.00) 70.65 67. Clean patio door(sliding glass)(per side) 1.00 EA 30.67 0.07 30.74 (0.00) 30.74 68. Clean door(per side) 2.00 EA 5.62 0.02 11.26 (0.00) 11.26 69. Clean window unit(per side)10-20 SF 1.00 EA 11.64 0.00 11.64 (0.00) 11.64 70. Containment Barrier/Airlock/Decon.Chamber 64.00 SF 0.63 0.28 40.60 (0.00) 40.60 2015-08-26-1109(1) 12/23/2015 Page:7 Servpro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 CONTINUED-Storage beneath porch DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 71. Content Manipulation charge-per hour 1.00 HR 34.78 0.00 34.78 (0.00) 34.78 72. Protect-Cover with plastic 100.00 SF 0.31 0.69 31.69 (0.00) 31.69 Totals: Storage beneath porch 18.96 1,294.44 0.00 1,294.44 Total: Main Level 50.61 5,447.94 0.00 5,447.94 Job DESCRIPTION QUANTITY UNIT PRICE TAX RCV DEPREC. ACV 73. Haul debris-per pickup truck load-including dump 2.00 EA 157.97 0.00 315.94 (0.00) 315.94 fees 74. Equipment setup,take down,and monitoring(hourly 1.00 HR 45.91 0.00 45.91 (0.00) 45.91 charge) 75. Add for personal protective equipment(hazardous 12.00 EA 8.69 5.42 109.70 (0.00) 109.70 cleanup) 76. Asbestos test fee-full service asbestos survey 1.00 EA 475.00 0.00 475.00 (0.00) 475.00 77. Negative air fan/Air scrubber(24 hr period)-No 5.00 DA 72.99 0.00 364.95 (0.00) 364.95 monit. 78. Add for HEPA filter(for negative air exhaust fan) 0.10 EA 189.76 1.09 20.07 (0.00) 20.07 Totals: Job 6.51 1,331.57 0.00 1,331.57 Line Item Totals: 2015-08-26-1109(1) 57.12 6,779.51 0.00 6,779.51 Grand Total Areas: 2,859.36 SF Walls 1,448.71 SF Ceiling 4,308.07 SF Walls and Ceiling 1,448.71 SF Floor 160.97 SY Flooring 372.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 437.83 LF Ceil.Perimeter 1,448.71 Floor Area 1,583.99 Total Area 2,859.36 Interior Wall Area 2,806.75 Exterior Wall Area 370.50 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length 2015-08-26-1109(1) 12/23/2015 Page: 8 Servpro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 Summary for Dwelling Line Item Total 6,722.39 Material Sales Tax 57.12 Replacement Cost Value $6,779.51 Net Claim $6,779.51 White,Brian 2015-08-26-1109(1) 12/23/2015 Page:9 Servpro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 Recap of Taxes Material Sales Tax(6.25%) Clothing Sales Tax(6.25%) Storage Tag(6.25%) Line Items 57.12 0.00 0.00 Total 57.12 0.00 0.00 2015-08-26-1109(1) 12/23/2015 Page: 10 i Servpro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 Recap by Room Estimate:2015-08-26-1109(1) Area:Main Level Living/Dining Room 697.75 1038% Porch 618.35 9.20% Sewing 366.13 5.45% Bed Closet 117.38 1.75% Girl's bedroom 437.88 6.51% Garage 1,645.20 24.47% Boys bedroom 128.80 1.92% Bathroom 110.36 1.64% Storage beneath porch 1,275.48 18.97% Area Subtotal: Main Level 5,397.33 80.29% Job 1,325.06 19.71% Subtotal of Areas 6,722.39 100.00% Total 6,722.39 100.00% 2015-08-26-1109(1) 12/23/2015 Page: 11 Servpro SERVPRO of Lawrence 2064 SERVPRO of Salem/Plaistow 5389 SERVPRO of The Andovers 5390 978.688.2242 office@servprooflawrence.com-PO Box 328 Lawrence,MA 01842 Recap by Category Items Total % CLEANING 1,681.70 24.81% CONTENT MANIPULATION 252.16 3.72% GENERAL DEMOLITION 2,736.29 40.36% PERMITS AND FEES 475.00 7.01% HAZARDOUS MATERIAL REMEDIATION 18.98 0.28% PAINTING 372.53 5.49% WATER EXTRACTION&REMEDIATION 1,185.73 17.49% Subtotal 6,722.39 99.16% Material Sales Tax 57.12 0.84% Total 6,779.51 100.00% 2015-08-26-1109(1) 12/23/2015 Page: 12 Main Level �--�15'11" 21'10" 24-6" 15'3" S'10„ 2' 9-8" 1 i, S t fV �p Sewing a N Girl's bedrooBoys bedroom iV -9'6"--� 0-63,11 51 1 Living/Dining Room T N 6.3'.�y � 4'9.. Garage N s'11° 1"+ ri= 4'1 'v Bathroom = 1 � i M 12'8" 7 r Storage beneath porch N 13'2" LPorchN Main Level 2015-08-26-1109(1) 12/23/2015 Page: 13 The Commonwealth ofMassa.chusetts Department oflndustrialAccidents r . d 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.govldia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TAE PERMITTING AUTHORITY. AAimlicant Information Please Print Le0bly Name(Business/Organization/Individual): VV MCX(2 t / 1_-(_J 5hl � n «C Address: / A Cad L Y I c/ City/State/Zip: l/Q�' l m v/ hone#: 7 c 9� 23 0 5 Are you an employer?Check the appropriate box: Type of project(required): l.fam a employer with_ (full and/or part time).* 7. 0 New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in $, &Wemodeling any capacity.[No workers'comp.insurance required.] 3.❑lam a homeowner doing all work myself[No workers'comp.insurance required.]t 9. El Demolition 10E]Building addition 4.❑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.❑Electrical repairs or additions proprietors with no employees. • 5.❑ • 12.0 Plumbing repairs or additions I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.FJ We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no.employees.[No workers'comp.insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. Homeowners who submif this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. (Contractors 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 fiave employees,ttiey must provide their workeis'comp.policy number.• lam an employer that is providing workers'compensation insurance for my employees.'Below is'thepolicy and job site information. Insurance Company Name: X�►(�fj ( ](��(� r("1 1 C�)� t�LJ Policy#or S elf-ins,Lie.#: M WC,CO 2A SE—] Expiration Date:_ 3 Job Site Address: 100 City/State/Zip:WW!l�Y)V 1"'k ng 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 Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify oder the in nd penalties ofpesjury that the information provided above is true and correct. Signafore: Date: Phone#: 7-2 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): ; 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 9 Massachusetts -Department of Q�q.4 of Build's Re Public Safety ' y , �yulatiarG a,-,d St-M-dards Construction Saperl icor License: CS-089332 W&LIAM MCKAV 18 Academy Avenfte Haverhill MA 01935 je \` Expiration Commissioner 03/08/2016 r` C-�e�orir�raoiuv��cl(�of C�/llc:»ac�rur./(:i --\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration: .1.79265 Type: Office of Consumer Affairs and Business Regulation xpiration 7/10/2016 LLC ! 10 Park Plaza-Suite 5170 Boston,MA 02116 W. MCKAY CONSTRUCTION LLC I WILLIAM MCKAY 18 ACADEMY AVE. t valid without signature HAVERHILL,MA 01835 Undersecretary No