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HomeMy WebLinkAboutBuilding Permit #908-2016 - 115 LANCASTER ROAD 2/23/2016 BUILDING PERMIT o`"�oT e,91'O TOWN OF NORTH ANDOVER 03? APPLICATION FOR PLAN EXAMINATION h nO " O Permit No#: `2—b ' Date Received �gssgc Hus���y PIP Date Issued: oz Z IM ORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER K` 'qe t I _ Print 100 Year Structure yes no MAP �d�- _PARCEL ZONING DISTRICT: Historic District yes o Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 18 One family ❑Addition ❑Two or more family ❑ Industrial tj�,Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others- ❑ Demolition ❑ Other El Septic El Well El Floodplain ❑Wetlands ❑ Watershed District 'Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name:_ �2,.L Phone: Address: \\-I Nv , b Contractor Name: Phone:_ Address: c 9 Y.w .'t S3-, _ Ny b`^� w•-�, I � . Supervisor's Construction License: US a 'k Exp. Date: 6 12A Home Improvement License: to l�_`t_�{ . _._. Exp. Date: IJIA[tt, ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �?� , u U FEE: $__ 14-1 Check No.: I`� Receipt No.: 3W5� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fu Signature of Agent/Owner ignature of contractor Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL Public Sewer `18 Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & 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: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$1oo-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email 1 Date Time Contact Name Doc.Building Permit Revised 2014 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 ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products . 9 9 g NOTE: 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 ❑ Workers Comp Affidavit ❑ 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 Calculationslicable If Applicable) pp ) o Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New ConstructionSin le ( g and Two Family) ❑ Building Permit Application ❑ Certified 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 ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: 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 $ 3%500.00 m $ - $ 474.00 Plumbing Fee $ 59.25 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 59.25 Total fees collected $ 692.50 115 Lancaster Road 908-2016 on 2/23/2016 master bath remodel NORT!j Town of F. - ndover 0 IL Z � �h � ver, Mass�C T 0 CO[N�C.M'tA C.M.C. 4ATED U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT BUILDING INSPECTOR now Foundation has permission to erect .......................... buildings on ...l Ato.... .. 1 ............,..%.,, ... Rough to be occupied as ....... . . .. ......J.A...Ift.V11W..... ..................................... 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 IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service .............. ... . ................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. t i { -- --- --- -- k KevinMUrphy 98 Forest Street North Andover,MA 01845 0 PH:978-688-5335 Building Contractor • FAX:978588-7207 Proposal 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 02108.(617)-727 8598 CC: Date: 2/22/2016 Job: Master bathroom Date of plans: 12/15 Architect: None Location: Same Section 1-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 fumished 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 Kevin Murphy Page 2 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:978£8&5335 FAX 978-688-7207 General Proposal is to renovate existing master bathroom. Permits will be obtained by contractor. Demolition Existing shower area and ceiling will be completely gutted. Other walls will be gutted as required. Tile floor will be removed. Carpets in master bedroom and spare bedroom will be removed. 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 owner, installed by contractor. Fixtures to remain in same locations. Electrical Electrical work required to renovate bathroom will be provided. Panasonice fan / light will be supplied and installed. Five inch recessed 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 be supplied/installed to code. Plaster Bathroom will be blueboarded and skimcoat plastered. Walls and ceiling will be smooth. Interior Trim/Doors 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 be applied to all 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 supplied, installed, and finished with three coats of oil based urethane,to match existing. Kevin Murphy Building Contractor Page 3 of 4 98 Forest Street North Andover,MA 01845 PH:97BZ86-53W FAX:978M&7207 Waste Removal All demolition/construction debris will be disposed of by contractor. Other Allowances An allowance of$2000 has been included to supply and install glass shower enclosure. MOVAMv�MUEDM7 Page of 4 Mullding Contractor 98 Forest street North Andover,MA 01845 PH:9784688.5335 FAX 978688-7207 Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of......... ... ... ... ......... ... ... ....$ 39,500 Payment to be made as follows: Percentage/item Description Amount 1 Permit obtained /deposit 2500 2 - Demolition Complete -- - __.._..._..--- $5000 3 Plastering complete $10,000 4 Tile complete $6000 5 Painting complete $5000 6 Hardwood floors complete $6000 7 Job 100% complete $5000 Total 17 _ _ - --- $39,500.100 . "Notice:No agreement for Home improvement contrac&q work shall require a down payment(advance deposit)of more that ona4hird ofthe total contract price of the total amount of all deposits or payments which the contractor must make,in advance,to order ardor oterwise obtain delivery of special order materials and equipment,whichever is greats Contractor: Kevin Murphy 98 Forest Street No.Andover,MA 01845 Registration No: 101874 Section V—Acceptance Acceptance of Proposal—1 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 Signature r" Date �•Zd� Signature Date The Commonwealth of Massachusetts Department oflndustrialAccidents g I Congress Street,Suite 100 Boston,MA 02114-2017 . www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Annlicant Information Please Print Letribly Name (Business/Organization/Individual):����� �..✓p�.vl, �`1 r _ T �A dz�_ Address: Si,6 City/State/Zip: Phone#: 1�.g Are you an employer?Check the appropriate box: Type of project(required): 1.G�I am a employer with�_employces(full and/or part-time).F 7. ❑New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in 8- Remodeling any capacity.[No workers'comp.insurance required.] 3.01 am a homeowner doing all work myself.[No workers'camp.insurance required.]t Demolition 10 0 Building addition 4.0 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 arc sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.E]Other 152,§1(4),and we have no employees.tNo workers'comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 Ili at is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.M VC..l% 3 3-1 3`I Expiration Date: -1 Job Site Address: �'1 �- c.k� top, City/State/Zip: Ny 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 Iterby certi rutder the pains and penalties ofper jury that the information provided above is true and correct. Sit=natttr � Date: 2 L1 Phone#: Official use only. Do not sprite 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#: DATE(MMIDO/YYYY) �R CERTIFICATE OF LIABILITY INSURANCE 12/11/2015 THIS CERTIFICATEIS ISSUED ASA MATTER OF INFORMATIONONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELYOR 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 REPRESENTATIVEDR PRODUCER,AND THE CERTIFICATEHOLDER. IMPORTANT:If the certiffcateholder Is an ADDITIONADNSURED,the policy(ies)must be endorsed.N SUBROGATIONIS WAIVED,subject to the termsandconditionsofthe policycertainpoliciemaymquireanendomementAstatementon thiscertiffcatedoesnot conferrightstothe certlflcateholder in lieu of such endomement(s). PRODUCER CONTACT NAME Sandi Munroe M P ROBERTS INS AGCY INC PHONE FAX A/C,No,Est: (978)683-8073 If. ,N.1: (978)683-3197 1060 Osgood Street E-MAILsandi@mprobertsinsurance.com ADDRESS: North Andover, MA 01845 INSUREIgS)AFFORDING COVERAGE NAICk INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURER B: GUARD INSURANCE 98 FOREST STREET INSURERC: NORTH ANDOVER, MA 01845 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, EXCLUSIONSANDCONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVEBEEN REDUCED BYPAID CLAIMS. ML SUM POLICY EFF POUCY EXP TVPEOFINSURANCE POLICY NUMBER MM'DD LIMITS X COMMERCUILGENERAL LIABILITY - EACH OCCURRENCE $ 1 000,000 CLAIMSMADE OCCUR PREMISES Ea ocwrmnce $ 500,000 BOP1068945 1/22/15 11/22/16 MEDEXP(Anyoneperson) $ 15,000 A PERSONAL&ADV INJURY $ INCLUDED GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 0 1E[ O- 9 ED LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT $ 1,000000 Ea accident / ANYAUTO BODILYINJURY(Perperson) $ ALL OWNED SCHEDULED MCA7013608 1/23/15 01/23/16 X BODILY INJURY(Per accident) $ A AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AU70S AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 F1 AEXCESS LIAB CIAIMS,MADE AGGREGATE $ 1,000,000 CUP9145304 1/22/15 1/22/16 DED RETENTION $ $ WORKERS COMPENSATION X PER OTK AND EMPLOYERS'LIABILITV STATUTE ER Y'" 500 000 B umcewerMnE��nea�xewnve r�N/A E.L.EACH ACCIDENT $ I (Mandatorlin NH)Le '�j1JJ' KEWC633734 7/01/15 7/01/16 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe Under 500 OOO DESCRIPTION OFOPERATIONS bet— E.L.DISEASE-POLICY LIMIT $ / DESCRIPTION OFOPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additionat Remarks SdmdNe,may neatta ited If rme space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF NORTH ANDOVER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01845 AUTHORIZED REPRESEN7A IVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety I Board of Building Regulations and Standards License: CS-053099 a Construction Supervisor KEVIN W MURPHY 98 FOREST ST ' r NORTH ANDOVE=R MA 041f4 ' r I � Expiration: t commissioner 06/29/2017 ' ��ie iPdr�7�iaoovcuea�.o�C�/�cr�aa�u�eC�• 'Office of Consumer Affairs&Busitless Regulation OME IMPROVEMENT CONTRACTOR egistration: ,101874 Type: xpiration,-;_6/29Y2096 Individual KEVIN MURPHY ij•� i' Kevin Murphy 98 FOREST ST. _ g N.ANDOVER M A 01845 `. Undersecretary Location No. 20��0 Date JJ . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $_► i4L-- Foundation Permit Fee $ Other Permit Fee $ J TOTAL $ T Check# Building Inspector