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HomeMy WebLinkAboutBuilding Permit #706 - 147 JOHNNY CAKE STREET 4/5/2012 TOWN OF NORTH ANDOVER - APPLICATION FOR PLAN EXAMINATION - Permit N0: Date Received Date Issued: ' 41 M IMPORTANT:Applicant must complete all items on this PLge LOCATION / IV r• PROPERTY OWNER Unit# Print MAP NQ/4)�Lg,PARCEL ZONING DISTRICT: Historic District yes Machin . _ e Shop Village yes 100 year-old structure yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building 'One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration. No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other ®,S p c O Well. Floo plain ©Wetlandsi' ® 1 . � y3 �, Watershed istnct.` .�.O�Water/Sewers - = s DSC NOF WORKTO BE PERFO D: d1� � (Identification Please Type or Print.Clearly) OWNER: Name: \/�l Phone Address: d CONTRACTOR Name: h2.nW �I Phone: : 7 a s8 Yc>3Z Address: Supervisor's Construction License: 1f Exp. Date:- Home Improvement License: l� l Exp. Date: - ARCH ITECTLENGINEER !U0 �� Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COSTBASED ON$925.00 PER S.F. Total Project Cost: $ cj /Z j • CS (� J FEE: Check No :No.:- �� - Receipt No.: (9,�, � NOTE: Persons contracting with unregisteYed conlrizctors Flo not have ac ess tfund :a'.s Y . i naturenofAgent/OwnerR¢6 '� _ �,, ,�Signatureof contractor Y ' � it g ' Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ 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 _ _ I DATE REJECTED.. DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Sinature COMMENTS HEALTH: Reviewed on Signature COMMENTS _ t 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 -Temum ori sem- es .no .- Located at 124 Main Street z P • Fire De artment signature/elate'gn ature/date t Dimension Number of Stories:__Total square feet of floor area, based on Exterior dimensions. - Total land area, sq. ft.: i k ELECTRICAL: Movement of Meter location, mast or service drop requires approval of I Electrical inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine i NOTES and DATA— For department use I, -------------- II y ® Notified.for pickup - Date i Doc:.Building Permit Revised 20117une/mi I . Building Department The following is aTst of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits IIS ❑ BuildingPermit mit Appllcatlon - ❑ 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 DOTE: 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 o Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract a Floor/Crossection/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 � NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) o Building Permit Application o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit o 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 MOTE: 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 mwst be submitted with the building application ' Doc: Doc.Building Permit Revised 2008mi I Location No. Date • - TOWN OF NORTH ANDOVER rda r Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ { TOTAL $ Check# 2 'Z iY 25156 Building Inspector NORTH own of2Andover - No. 70 LAKE o dover, Mass., COCMICMEWICK %AD"�ATED P'P�,`°`� `S U BOARD OF HEALTH PER .M IT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.........a ..to$........... .ft.f..4k7! Foundation has permission to erect... ............ buildings on.....�. ....... .. .... 1%a !N�...C^..(CM............. Rough ..........:.............. to be occupied as....... ... ,. !�. w. Chimney provided that the pe ccepting this permd shall In every respect conform to the terms of the application on file in Final 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 PERMrF EXPIRES IN 6 MONTHS w ELECTRICAL INSPECTOR UNLESS CONST'RUCI"IS Rough — ............................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Fina, No Lathing or Dry. Wall To Be Done FIRE DEPARTMENT, Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE S0®E Smoke Det. f The Commonwealth of Massachusetts 114 M Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA.02111 www.massgov/dia Workers' Compensation Insurance.Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information �i Please Print Legibly Name(Business/Organization/Individual): Address: 6�Wna ea Ssw e. City/State/Zip:, Phone Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. [9 I am a general contractor and I ` 6. ❑New construction employees(fall and/or part-time).* have hired the sub-contractors 2.EJI am a sole proprietor or partner- listed on the attached sheet.? �• Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. workers'comp.insurance. g• Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10. Electrical repairs or additions. 3.El am a homeowner doing all work right of exemption per MGL 11.[]Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]► employees.[No workers' 13.[]Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they Are doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c.152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office sof Investigations of e DIA for insurance coverage verification. Ido hereby c der i pains and penalties ofperjury that the information provided above is true and correct. - Signature: Date: Phone Official use only. Don t write in this area,to be completed by city or town offrcial. 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#: Frorn:Benn!e FaxID:9784549343 Page 1 of 1 DateA.1412012'h:5C ANI Page:1 of 1 CROWC01 OP ID: BW A ? CERTIFICATE OF LIABILITY INSU INCE �DAI04)'0DDrYYYY; 0410411^c THIS CERTIFICATE IS ISSUED-AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTFICATE 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 BE71VEENN THE ISSUING INSURER(Sl, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: 11 the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. rf 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 confer rights to the certificate holder in lieu of such endorsement(s). ^� PRODUCER NSA CT Francis Provencher Insuranre -sHow: - - -- _ -- Agency, Inc. 978.4.4.5343 AIC,No.Ext), ----- — ''-N-- 530 Roger Street Iii E-MAIL - -- ---� ------- Lowell,MA 01252 ��--- ------ ------- ---T -- _ ^ER(S)AFFC_RGINGE CC'JE3aG r•,sLtER,� Lloyds of London _...-- — - ------ INSURED Crovilley0onstsuction Generatl _ INSURERS Citation insurance Company —r40?74 Contracting Inc. ------._--- ---- 54 Long Pasture Road ----------------- --_.—__-- N.Andover,MA 01845 NSUREZ D. INSUR.ER E: I INSUPFr't F i COVERAGES _CERTIFICATE NUMBER: REVISION NUMBER'. THIS 15 TO CER7IFY THAT THE POLICIES OF 1NSJRANCE US7ED BE'OVI HAVE BEEN ISSUED T3 THE INSURED Nf•MED ABOVE FOR THE POLICY PERIOD NDICATED. NOT ANITH•STANDING ANY REQIJIR.EMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT LJVITh RESPECT TO 01HICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE .AFFORDED BY TF.E POL!C;ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOVA'N MAYHAVE BEEN REDUCED BY PAID CLAIMS. r:9Ft -- —?ADDL'SUE7----- --- ------- iLZS'TF€—T<cCl�l EXE— -- ------- -- RAF- TYPE OF IN£URANCE 1 4--- rOUCY NUMEER �L1P.!lODIYYYY! ;IJMiGGl1'YYYI i.iMiT5 GENERAL LIABIL17Y ! 1,000,000 A X I �'(I;'t. yL c.`d(= r`L LS.31L LGL1D20177 02fC3i12 02!03113 ,1,7 �+ 100.000 __...— -- -�CLQ t`, np_F 0^CUR 1iC=,F , _ s..�l, - 1,000 I I —1,000,EGO 2,000,000 1 E•i A-%-RECS„T=LIMIT -FPLIFS 1,000,000 iD N _P.11Tv� ;.IGLE_ �--- AUTOfu10E1LELIAEILIT ! ,_ -:i AMY VJT�. i BCZQXX 09!12!11 09! •'12112 Eo w;o e+_ ) � 100,000 -!ALI.Cv,rr2ED =',_HEDULED BpGIL`: !�!.iVt-,v :.;,iranil-may-- 300.00 X IIRZ7_A ,,;; 100,000 UMBRELLA Like ��•����� �j --- i EXCESS UAB WORKEM COMPENSATION T— M—' - X7.7"' 1•"�'�"FTi ' AND M-1.0 ERS LIABILITY _ •N1A I r.. 'IUFN— .--1--------- (Mandatory in NH) F.L.G!:_E.ASE-_H_Iv P:C. -- I!ye, d?3i(I:r3Ui.rJ.r I --'-- - DESC.'.I�- F,»Ca;;-IONS piwi I -_ DISEASE.Fr,-,!_,-, L.11,111 I I i i i DESCRIF710r,I OF OPERATIONS i LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Scheclu!e,if more space ie ragoi,ed� CARPENTRY-RESIDENTIAL NOT EXCEEDING 3 STORIES "CERTIFICATE FOR WORKERS'COMP COVERAGE WILL BE ISSUED DIRECTLY FROM THE COMPANY WITHIN 2 BUSINESS DAYS"" I CERTIFICATE HOLDER CANCELLATION eHO!JLD ANY OF THE ABOVE DE8CRIBED POLIC13 BE CANCELLED BEFORE I THE EXPIRATION DATE THEREOF, NOTICE 1NILL BE DELIVERED IN 'Town of N.Andover ACCORDANCE WITH TME POLICY PROVielONS, ATTN: Building Dept. !,JTHOR¢EDREPRESEVr.arwE 1600 Osgood St. N.Andover, SAA 01845 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010i05) The ACORD name and logo are registered mark.;of ACORD :Bonnie FaxID:9784549343 Page 1 of 1 Date:4/4/2012 10:55 AM Page:1 of 1 CROWC01 OP ID: BW CERTIFICATE OF LIABILITY INSURANCE r DAT 04104DIYYYY) 04/04/12 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(les) 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 confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER 978459-8681 NAME: Francis Provencher Insurance97854-9343 PHONEFAX Agency, Inc. AIC No Ext): AIC No): 530 Rogers Street E-MAIL Lowell,MA 01852 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC i INsuRERA:Lloyds of London INSURED Crowley Construction General INSURER B:Citation Insurance Company 40274 Contracting Inc. INSURER C: 54 Long Pasture Road N.Andover, MA 01845 INSURER D: INSURER E 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY POLICY XP LTR INS WV POLICY NUMBER MM/DDIYYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY LGL1020677 02/03/12 02/03/13 UAMAULIUHhNILD PREMISES Ea occurrence $ 100,000 CLAIMS-MADE r—xl OCCUR MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY 7 PRO- LOC $ AUTOMOBILE LIABILITY Ea eBINEDtSINGLE LIMIT $ B ANY AUTO BCZQXX 09/12/11 09/12/12 BODILY INJURY(Per person) $ 100,000 ALL OWNEDX SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ 300,000 X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ 100,00 AUTOS Per accident 0 $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ITORY IT ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F7NIA E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101 Additional Remarks Schedule,if more space is required) CARPENTRY-RESIDENTIAL NOT EXCEEDING 3 STORItS "*CERTIFICATE FOR WORKERS'COMP COVERAGE WILL BE ISSUED DIRECTLY FROM THE COMPANY WITHIN 2 BUSINESS DAYS" CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of N.Andover ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: Building Dept. AUTHORIZED REPRESENTATIVE 1600 Osgood St. N.Andover, MA 01845 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD i 91te 20 Otfice of Consumer Affairs ; nd usiness Regulation 10 Park Plaza - S`izite 5170 Boston, Massachsetts 02116 Home Improvement r4or Registration Registration: 114181 .� r# 217687 CROWLEY CONSTRUCTION & G 0 2 N STEPHEN CRCWLEY X 54 LONG PASTURE RD. w g --- - --- NO. ANDOVER, MA 01845 -- -- — ` i I c ���� anon for chance. _ v ` ,nt - Lost C2rd ..DPS-CA1 0 50M-04/04-G101216 J � W enLicense>>r tegistr:uMmeA oOfficeoop HONME IMPROVEMENT CNTRACTOR hefore the ezpirat c Registration: ,.114187 Type: Office o'Cattsu_mi Expiration 8/11!2013 DBA 10 Park Plaza-Si U 1� `� Boston,NIA 0211, 0 -j Z C C "'LEY CONSTRUC�T1QN&G.0 [�7]1 Z �, STEPHEN CROWLEY .,- z co Her 54 LONG PASTURED NO.ANDOVER,MA Q1845 Undersecretarc Not valio i. r - CROWC01 OP ID: BW CERTIFICATE OF LIABILITY INSURANCEF7ATE(MM' YYY) 02!0O33/111 2 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(ies) 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 confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER 978-459-8681 NAME: Francis Provencher Insurance 978-454.9343 PHONE FAX No Agency,Inc. 630 Rogers Street ADDAIESS: Lowell,MA 01862 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Lloyds of London INSURED Crowley Construction General INSURER B:Citation Insurance Company 40274 Contracting Inc. 54 Long Pasture Road INSURER C: N.Andover, MA 01845 INSURER D: INSURER E: 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. INSR TYPEOFINSURANCE ADDLSUBR p LICYNUMBER POLICY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY PENDING 02/03/12 02/03/13 PREMISES Ea occurrence) $ 100,00 CLAIMS MADE OCCUR MED IXP(Any one person) $ 1,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,00 POLICY IFCT PRO- LOC $ ACOMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ B ANY AUTO BCZQXX 09/12/11 09/12/12 BODILY INJURY(Per person) $ 100,00 ALLOWNED X SCHEDULED BODILY INJURY(Per accident) $ 300,00 AUTOS AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ 100,00 X HIRED AUTOS X $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,descr be under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMB $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101 Additional Remarks Schedule,if more space is required) ARPENTRY-RESIDENTIAL NOT EXCEEDING 3 STORItS CERTIFICATE FOR WORKERS'COMP COVERAGE WILL BE ISSUED DIRECTLY FROM THE COMPANY WITHIN 2 BUSINESS DAYS" CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of N.Andover 1600 Osgood St. AUTHORIZED REPRESENTATIVE N.Andover,MA 01845 ©1988-2010 ACORD-CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Stephen Crowley CROWLEY CONSTRUCTION 54 long Pasture Road North Andover,MA 01845 978-258-4932 tele/fax crowlevconstruction@comcast.net Estimate Prepared For: License: MA Reg.: 114187 MA Lic: 058114 Steve and Laurie Cavazza 147 Johnnycake 4mw *- North Andover, MA 01845 978-688-4376 Scope of Work: Master Bathroom: We will gut entire bathroom down to studs(ceiling,walls,etc)remove all tile off floor and subfloor; remove subfloor plywood;remove hot tub,shower,vanity;cut bathroom down to subfloor;we will open up subfloor for Steve Galinsky to reroute all plumbing and to switch plumbing locations for Proline drain systems in new custom shower floor;we will need to build a 2x4 wall against existing back wall of common bathroom;the purpose of this wall will provide for new vent locations for old shower which will become the new vent line for soaking tub-this wall will all provide an area to remove existing vent line in common bathroom enabling us to frame off for vanity mirrors in common bathroom;after framing off wall and all plumbing has been relocated to accept new plumbing fixtures including custom shower,we will plywood entire floor and frame knee walls and soffit walls in ceiling for the fabrication of the custom shower;soffit system will be a structural system which will enable us to hold custom fabricated stone on shower ceiling;after all framing has been completed for shower area,all new plumbing has been put in walls and all new electrical has been installed throughout entire bathroom we will install new insulation on all exterior walls;exterior wall where custom shower is being fabricated we will put an additional inch of hard styrofoam insulation on entire exterior wall. All moisture resistant sheetrock will be installed in entire bathroom area including ceiling;we will install the custom Proline drain in shower prior to installing Durarock cement board in entire shower area before being able to install custom granite throughout the entire shower area; both inside and outside of knee walls and soffits(sitting bench inside and end walls along with cap walls)will all be manufactured out of custom granite chosen by customer. To make custom bench inside shower we will build a form and pour a concrete seat on which we will apply the custom granite on the face and seat in shower. Prior to applying any stone we will plaster all existing areas of bathroom(walls and ceilings)will be flat plaster; all other areas of shower will be cement board and custom fabricated granite for shower. All plastered areas(ceilings and walls)will be sprayed primer sealed before applying stone. Pdge 2 When stone has been applied and the Proline drain installed we will install a wire mesh base on floor with skim coat before applying the into Proline drain system. The tile on bathroom floor and custom shower floor need to be slightly pitched at door entrance way to receive proper drainage in Proline drain System. We will install a Florida Livingston Gold(13x13)the on floor. We will have a custom threshold made at doorway out of granite used for shower. We will also have a custom top made out of same granite for vanity with backsplash. This vanity will have a custom under mounted sink mounted to stone. We will install new six-panel solid pine door with new trim;we will install all new baseboards in bathroom and new trim around two bathroom windows;all trim for doors,windows and baseboards to match existing trim in home;interior bathroom trim to have one coat primer seal paint and two coats of finished oil based paint installed;on door exiting bathroom will be painted white on inside and stained and poly.on the outside;the same will be done to door trim. Inside master bathroom around entire perimeter area we will install a two-piece custom crown molding. The crown molding will have one coat primer paint and two coats of finished oil based paint installed; inside bathroom walls will have two coats of finished paint. We will install a custom claw foot tub which will sit in bathroom(location to be discussed with customer);all fixtures in bathroom to be installed by Steve Galinsky and Crowley Construction due to weight of same;this applies to the Proline drain system as well because of the process of installing this system. We will also install two custom vanities in this bathroom one for sink and the other will go to the far wall;we will provide solid blocking in walls to install both vanities in bathroom for securing;vanity to the left of sink will have custom crown molding installed(shown in drawings);we will install all necessary accessory fixtures in bathroom;we will drill the custom granite in shower for accessories. Upon completion of bathrooms we will secure a custom glass fabricator to look at both bathrooms and provide us with an estimate for glass. When construction is complete we will ensure bathroom is ready for full usage. We will clean and seal tile floors. SII Page 3 Electrical: We will relocate all electricity to accommodate new bathroom. We will relocated the GFI plug in bathroom for vanity;we will relocated and install lights at each side of vanity mirror;we will install a custom shower light inside of custom shower and install 9 reset lights in interior of bathroom (10 lights in all). Total Cost of Project: $22,500.00 We will supply all necessary material and fixtures. Breakdown: $10,000 $7,500 $5,000 All debris to be removed from job site. As evident by the signatures below both parties have read and agree to the above estimate. Stephen Crowley is fully licensed in the State of Massachusetts. -- - f Member of the Better Business Bureau. ,. BBB Stephen Crowley Homeowner Stephen Crowley CROWLEY CONSTRUCTION 54 Long Pasture Road North Andover, MA 01845 978-258-4932 tele/fax crowle construction corncast.net Estimate Prepared For: License: MA Reg.: 114187 MA Lic: 058114 Steve and Laurie Cavaua 147 Johnnycake 6-me-;+- North ame5+.North Andover, MA 01845 978-688-4376 Scope of Work: Common Bathroom in Hallway: We will gut entire bathroom down to studs(ceilings,walls,tile floor,vanities,toilet and tub); remove subfloor plywood bringing flooring in bathroom to the first 3/4 tong-n-grove plywood;remove both linen closet door in bathroom and bathroom door;we will use bathroom door in place while we are gutting entire bathroom to prevent dust from traveling throughout home;we will remove all debris through window throughout entire gutting of bathroom;prior to starting any demolition we will cover in staircases,rugs and all floors while under construction including master bedroom and hallway; we will install a special plastic that sticks to carpeting both on floors and up staircase;we will want to keep this material in place while under construction;after entire bathroom has been gutted we will install all new insulation on rear wall;we will install insulation between both bathrooms for sound proofing;wall in bathroom for medicine cabinets will need to be entirely framed off for three medicine cabinets to be installed;each medicine cabinet will be centered over vanities;when new plumbing has been modified to receive new fixtures in both vanities and shower area we will install new 1/2 in.plywood on bathroom floor;we will install moisture resistant sheetrock in entire bathroom area except for area of new tub where the is installed at that area we will install a Dura-rock cement board;after sheetrock and Durarock has been hung we will install a skim coat plaster on all walls and ceiling;ceiling and walls will be all white flat plaster;we will only plaster in sheetrock to Durarock where they both meet,the Durarock will stay exposed to receive tile in tub area. Prior to installing tile we will primer seal all walls with bathroom paint;we will install all new trim on windows;install two brand new doors(solid pine)to match existing doors in home;all trim work around windows and doors(including baseboards)will match existing trim;interior trim on windows, baseboards and doors inside bathroom will all be painted with primer sealer,two coats of finished white oil based paint. Outside bathroom door will be stained along with outside casing to match existing stain in home;on jam of door we will split the jam in half(one side stained-one side painted oil based white); After all woodwork and doors have been installed we will paint two coats of finished paint on all walls and ceiling(color to be chosen by customer);after walls have been painted we will install vanities with vanity mirrors;we will need to have a solid granite top custom made for bathroom with double under- mounted sinks. Page 2: Prior to tiling floor we will install a wire mesh over subfloor plywood,stapled down and we will install a thin set mortar over wire mesh before application of a Novabell stone(12x12)tile for floor;in shower area we will also install this same tile from tub to ceiling and the color of the stone does come with a 3x12 cap. Inside of shower area we will install a 12x12 deco strip which is 5/8 in.thick that will go around entire tub area on all three walls(height to be determined by customer);after entire bathroom has been completed and everything has been installed;we will install curtains and/or shades on windows. We will give a final cleaning throughout bathroom once construction is complete and will seal all tile both on floors and walls.(color grout needs to be chosen for floors and walls). We will install all necessary bathroom accessories. Electrical Note: we will reroute any wiring that needs to be addressed for new vanities;we will install two GFI plugs at new vanity area;there will be three lights(one above each mirror);we will install a bathroom exhaust fan which was outlined in the Peabody Supply quotation. We will install new exhaust duct for that fan exiting bathroom. We will supply all necessary materials. Total Cost of this work: $15,625.00 Breakdown: $8,000 $5,000 $2,625 All debris to be removed from job site. As evident by the signatures below both parties have read and agree to the above estimate. Stephen Crowley is fully licensed in the State of Massachusetts. --- i Member of the Better Business Bureau. BBB Stephen Crowley Homeowner