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HomeMy WebLinkAboutBuilding Permit #704 - 16 GREEN HILL AVENUE 4/4/2012I BUILDING PERMIT O�ttl ED ;a 1ti0 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION 4 e # * I,* Date Received °qArev Permit N0: �SSAGHUS�t Date Issued: -z' IMPORTANT Applicant must complete all items on this page x;... S a s.. e.`r �m� n a, ;, t`'�r�" °r,"`e5 `001, .�Tit` "' A w ` h ' n r + Al.t' + '��' •,�.�.�As..l .� .-3'7^`�..rt 1 #"FSR FEFtT OWNER �� �� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building /One family El Addition El Two or more family . El Industrial XAlteration No. of units: Q Commercial [I Assesso Bldg El Others: Re air ry ,oRepair, replacement ❑ DemolitionWe ❑ OtheraitUater lied �sErit ' ® Sept c= i$Welt t rFloodp -h s D tiands ,g l�� Q'�`Il�fiater/Sew��i•�,�����`�.�v���� ��;,_ �-�°��#.��_� ��,F _.�_,.��„ �.� � � �. ��-3 � __�:�...�.Y,..� r DESCRIPTION OF WORK TO BE PREFORMED: �- Identification Please Type or Print Clearly) - ? Z Phone. OWNER: Name: ri 4 } Address r kt `, J ,„'r . kr rD a ,. ._ .€ .tri`, -?e����"•�, �' "u tr s.'F4" S"�Y,p�'ry 'f a? sl .�- Y'ii ','1�%3 m �5z axr n.T x n uh�ne.�:. C�Rlal�'Rp,GspRrNarne YtxK -. ..;+' "zi:., f s ray .;� Address 4 �''�i"' .,,`� x,�' "4! `s" �'$'";s. t" t' s.4,,' � m+c'` -';^; 1} i xT i�,, ..#^x,� ,{ .i- ' '"''* yc.z ;- r•#�e t W'_ a �"�� '�a�s�rt ��� ��� .!°w.xY`? ��,E-,'�_�'' mss`^ ::+�..�'a.'r"^ty" ^3';� �,... „��-0�x"c: r -���/s yz r�x r�•�lTsap. � Jam` '3.: 9; � �� ��. �'":*1.:,Lx sy '�..; �Q {wa'$ ky,- �� �={X'4 � � k x T•Y�Exp�',`Da`V�i�`ra f Kt:`+' .2rHN ����41..�: §supervisor's Construction�,L�cense�..� �" '� 5t � -�- K � -�. � � ���•-���� �� <E " ,Horneflrnprorrement,LlcenSe -� �`� �� _�+�� _ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: FEE: $ Check No.: 0)1 1 S Receipt No.: NOTE: Persons contracting with unregistered contractors do not have acce to the guaranty fund ,; �f AS z Signature gent/Qwner r ,- _ . ` �s ignature of contra or` s 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 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/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) ❑ 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 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 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ 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 Located at 384 Osgood Street Driveway Permit FIREYdEPA� TME;NT em T ' X p Dumpste ,ort situ yes r '. r no - . Located at 124F1VIain Street, `� �Y , , r �' i 'i-+. � �. ;x''� *.:. ,.ia �.�.•„>� ti$�'s;t �.�e z- ,a's ror- w' ,a � ayY ,_y. �. . ��,,. .,.rZ k �, COM#VIENTS .3 - 2 xr ,¢ 2r., c` >r«k « s.,;r ..y -vr +P ^' �." '.K` za .,F k r - .,t • "h r Com, d �y-.. 3V� S .v 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 N Electrical Inspector Yes pp j No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 r Location /!/ L At// No.— l� Date • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ , Building/Frame Permit Fee F - Foundation Permit Fee $ Other Permit Fee $ IT TOTAL $ Check# 311 ("e 25154 Building Inspector tAORTH- TOVM Of .. . No-. Y 7 6t+ It" LAKE X - 10 dover, Mass., A_ COCHICHEWICK M 7d ADRATED l S V BOARD OF HEALTH i Food/Kitchen Septic System PERMIT T D BUILDING INSPECTOR THIS CERTIFIES THAT............. .. V. .................. Olt.. ... .!t.......................... ....r... .............................. Foundation has permission to erect........................................ buildings on .....�.�......�'1� .. .t.. ......... !� Rough to be occupied as t1c.t.. � !! .. .. Chimney ................ .......... .... ........... ................................ ...................................... provided that the person accepting this permit 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, Afterafion 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 CONSTRUC ST S Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Ocatpy Building' GAS INSPECTOR Rough Display in a Conspicuous Place. on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIR_ E-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner. Street No. SEE REVERSE S9 DE Smoke Det. CCAPLLC-02 LLAVALLEE DATE(MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 8/3112011 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 endomement(s). TACT PRODUCER License#365077 NAME Clark Insurance HONENo, (603)622-2855 FAX No):(603)622-2854 500 Commercial StreetJAIC E-MAIL #404 ADDRESS: Manchester,NH 03101 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance 24198 INSURED INSURER B:Excelsior 11045 CCAPS,LLC dba Service Master Elite&MAJE,LLC dba Elite INSURERC:Chartis Casualty Company Construction INSURER D:Philadelphia Ins.Co. 12 Continental Blvd Merrimack,NH 03054 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTSR ADDLSUBR TYPE OF INSURANCE INSR WVD POLICY NUMBER MWDDY EFF Myo EXP RLIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY CBP 8863091 8/29/2011 8/29/2012 PREMISES Ea occurrence $ 100,000 CLAIMS MADEOCCUR MED EXP(Any one person) $ 5,000' PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY SCOT LOC $ AUTOMOBILE LIABILITY EO aB d n SINGLE LIMIT $ 1,000,000 B ANY AUTO BA8863291 8/29/2011 8/29/2012 BODILY INJURY(Per person) $ X ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PPReOr ecEGRde DAMAGE $ AUTOS $ X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE CU8862891 8/29/2011 8/29/2012 AGGREGATE $ 5,000,000 DED RETENTION$ $ WORKERS COMPENSATION X INC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER C ANY PROPRIETORIPARTNER/EXECUTIVE Y/N 005-84-9433 8/2912011 8129/2012 E.L.EACH ACCIDENT $_ 1,000,000 OFFICER/MEMBER EXCLUDED? 1-Y] N/A (Mandatory in NH) E.L DISEASE-FA E PLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1,000,000 D Pollution PHPK764820 812912011 8129/2012 CPL—per occurence 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) I 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. AUTHORIZED REPRESENTATIVE For Informational Purposes ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts. Department of Industrigl Accidents Office of Investigations qu 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): ] l N-T7 r7�. Address: City/State/Zip: � 2 �►�l�lace `N�k Phone#: Are you an employer?Check the appropriate box: Type of project(required): I.[Jam a employer with �� 4. El am a general contractor and I 6. ❑New construction employees(full and/or-part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• ❑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. El We are a corporation and its required.] officers have exercised their 10.El Electrical repairs or additions 3.❑ I 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.]i employees.[No workers' 13.[i Other comp.insurance required.] 'Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they aie 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. I am 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.#: -f�–EE��-—cl k'-3 Expiration Date: Job Site Address: i Ll PCO E. City/State/Zip: 1L4 r 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 the DIA for insurance coverage verification. I do hereby cert un r the pa' and penalties ofperjury that the information provided above is true and correct. - Si afore: Date: 1 Z Phone#• 2 � c7� 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract ofhire,• express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. lir an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permithicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or'-permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance.for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of j\4_assaehv..sPtts Department of Industdal Accidents Office of Investigations 600 Washington Stroet Boston,SIA,021 X i TO,#61.7-727-4900 oxt 406 or 1.-877,7MA.SSA.FE Revised 5-26-05 Fax#617^727-7749 www.rxtass,govldia ELITE CONSTRUCTION Contract for Construction Services 1. Authorization to Perform Construction Services. ("Customer") authorizes and contracts with Elite Construction LLC, to perform any and all construction services to repair the structure(s)on Customer's property located at:� t�,�4..11 (the"Property"). 2.Scope of Work. The Services will be particularly described in the scope of services to be provided to the Customer by Elite Construction LLC after it has conducted a walk-through with Customer's Insurance Co.0p(the"insurance Co."),and has determined the most effective restoration procedures to accomplish the Services. 3.Cost of Services. The cost of Services will be commercially reasonable and will be determined in accordance with standard industry practices and utilizing a computerized estimating system called Xactimate. Additional information regarding this pricing methodology will be furnished to Customer upon request. Customer agrees to this method of pricing. 4. Customer's Payment Obligations. Customer agrees he is responsible for his insurance deductible(if any). Customer hereby irrevocably authorizes Elite Construction LLC solely and directly for any Services. If any Insurance Co. check should come to or be made payable to Customer,Customer agrees to pay Elite immediately upon receipt of such check. Customer agrees that he is personally and fully responsible for any and all deductibles.Contractor agrees to negotiate an agreed cost and scope with the insurance Co. and complete the project in accordance with that scope and for the insurance proceeds. Contractor agrees to not bill customer for any additional costs beyond insurance proceeds(excluding deductible), unless those overages are agreed to by both contractor and customer in writing. 5. Disbursement of Insurance Proceeds/Priority of Payments. Customer agrees that immediately upon receipt of any insurance proceeds, Elite's outstanding invoices shall be paid first in their entirely before any other contractors or suppliers are paid. 6. Interest on Overdue Payments;Costs of Collection. Customer and contractor agree that any interest or collection costs will only be assessed if customer is the party responsible for withholding or delaying payment. Contractor recognizes that insurance companies and mortgage companies will be involved in payment and may delay the payment.process. Both customer and contractor recognize that the customer will not bear any costs or penalties due to bank or insurance company delay. 7. Elite's liability. Elite's liability is expressly limited to the total amount paid by Customer for the Services. Any warranties made by Elite in connection with this contract shall be null and void in the event of a breach by Customer of any of his payment obligations. S. Insurance Co. Inspections. Customer agrees that in the event his Insurance Co. notifies Customer that it plans to inspect the Property. Customer will immediately notify Elite so that it can be present for such inspection. 9. Confidential Information. At times,Elite may share certain confidential business information with Customer. This includes information regarding pricing and business methods. This information may not be disclosed to other parties without the advance written consent of Elite. The Insurance Co.may use this information ONLY to process Customer's claim. 10. Nature of Contract;Binding Agreement. Customer understands that this is not a contract of insurance. Customer agrees that Elite is working for the Customer and not the Insurance Co, Insurance Co's agent or adjuster,or public adjuster. Customer understands and agrees that neither his Insurance Co. nor any of its agents has the right to cancel this contract. This contract is binding and enforceable upon execution by Customer and supersedes all other agreements or understandings(written or oral)made prior to execution of this contract. Customer agrees to utilize and remunerate Elite Construction to perform reconstruction services of at least sixty percent (80%) of the monetary value of insurance proceeds. Should customer not fulfiil upon this obligation,customer agrees to compensate Elite construction as remuneration for estimating,negotiating and consulting on the re-construction project. 11. Customer's Representations and Warranties. Customer represents and warrants as follows: a)he is the record owner or authorized agent of the record owner of the Property and has full authority to enter into this contract;b)his homeowners insurance policy was in full force and effect as of the date of the loss and that such policy is adequate to cover the cost of the Services;c)the homeowner's insurance policy and its proceeds have not been assigned to any other party; d) he will execute any documents required to process the payment of Elite's invoices; and 3) he has read this contract in its entirely and understands and agrees to its terms. 12. Miscellaneous. As used in this contract, all pronouns and all defined terms shall be deemed to refer to the masculine,feminine, neuter,singular or plural,as the identity of the person, persons, entity or entities or the circumstances may require. If any part of this contract is deemed to a invalid or unenforceable to any extent;the remainder of this contract shall not be affected and each remaining provision of this contract shall be valid and enforceable to the fullest extent permitted by law. ACCEPTED AND AG E D: CUSTOMER: I` Signature: f V Date: 2_1 23 , °2 Printed Name: Title: d 12 CONSTITUTION DRIVE MERRIMACK, NH 03054 " 603/888-4100 SERVING NEW HAMPSHIRE, VERMONT, MAINE AND MASSACHUSETTS I MassachusettsflMassachusettsMassachusettsCI - D• 111-tMent Of P2.';'I;' S.If"N 6().tT'(I 4 Puil(4o, Ri;,,,uladbns and St.111(i.ir(1s Construction Supervisor License License: CS 55348 Restricted to: 00 FRANK J TAMBONE JR 432A RIVER RD A-1- TEWKSBURY, MA 01876 Expiration: 6/24/2012 Commissioner Tr#: 27230 ✓!ze�mxmzanaecc� a�✓�aaaae/auael�a Office of Consumer Affairs&Business Regulation = OME IMPROVEMENT CONTRACTOR Registration:-:165712 Type: Expiration:.-3/22/2014 Supplement MAJE LLC./dba Elite-Consfru_don ELITE CONSTRUCTION FRANK TAMBONE 12 CONTINENTAL BLVD-.-.' MERRIMACK,NH 03054 Undersecretary Elite Construction 12 Constitutional Blvd Merrimack,N.H 855.Elite.00 Insured: Paul Lambers Home: (603)231-1979 Property: 16 Green Hill Avenue Cellular: (978)764-7256 North Andover,MA Home: 16 Green Hill Avenue Andover,MA 01845 Estimator: Frank Tambone Business: (603)233-7599 Contractor: Company: Elite Construction E-mail: frank@elitesvm.com Business: 58 Pulaski Road Peabody,MA 0.1960 Claim Number: Policy Number: UNKNOWN Type of Loss: Water Date Contacted: 2/17/2012 12:16 PM Date of Loss: 1/20/2012 12:00 AM Date Received: 2/15/2012 12:00 AM Date Inspected: 2/17/201212:15 PM Date Entered: 2/17/2012 8:13 AM Date Est.Completed: 2/20/2012 3:23 PM Price List: MAEM7X_FEB12 Restoration/Service/Remodel Estimate: PAUL_LAMBERS-ACT Estimate has been prepared based on our visual inspection.We've made every effort to prepare an accurate scope,should additional work be required we'll notify you immediately.Estimate excludes code upgrades,permits,unforeseen repairs,and/or hidden damages unless otherwise noted.Estimate includes labor and materials(unless otherwise noted)based on the allowances within the estimate. Please contact me directly should you have and questions Frank Tambone 603.233.7599 Frank@elitesvm.com Elite Construction 12 Constitutional Blvd Merrimack,N.H 855.Elite.00 PAUL LAMBERS-ACT LOWER LEVEL LOWER LEVEL QNTTY DESCRIPTION NOTE;DAMAGED CAUSED BY A LEAKING DISHWASHER ****NOTE*****PRELIMINARY ESTIMATE--AT THE TIME OF THE ESTIMATE SERVICEMASTER WAS NST BEGINNING TO WORK ON MITIGATION/REMEDIATION.ONCE THEY COMPLETE THIS,I'LL RETURN TO THE SITE AND REVISE THE ESTIMATE ACCORDINGLY MAIN LEVEL Height:7'8" Kitchen QNTY DESCRIPTION 1.00 EA 65. Wall demolition/repair/prep for paint 1.00 EA 8. Refrigerator-Remove&reset 1.00 EA 9. Remove Cooktop 1.00 EA 10. Remove Built-in oven 1.00 EA 61. (Install)Range-freestanding-electric 1.00 EA 11. Range hood-Detach&reset 1.00 EA 13. Sink faucet-Detach&reset 1.00 EA 14. Garbage disposer-Detach&reset 1.00 EA 15. Dishwasher-Detach&reset 13.00 LF 16. Remove Cabinetry-lower(base)units 19.50 LF 17. Cabinetry-lower(base)units 17.00 LF 18. R&R Cabinetry-upper(wall)units 3.00 LF 19. R&R Cabinetry-full height unit 4.00 LF 20. R&R Cabinet valance 12.00 LF 21. R&R Filler/scribe board- 1"x 4" -hardwood 20.00 LF 22. R&R Toe kick-pre-finished wood- 1/2" 24.00 LF 23. Cabinet moldings Note:Cabinet crown moldings 26.00 EA 25. R&R Cabinet knob or pull 60.00 SF 26. Remove Ceramic tile-backsplash 126.50 SF 27. R&R Sheathing-plywood-3/8" Note:Includes two layers of linoleum 63.25 SF 28. Remove Ceramic tile Note:Continuous floor 110.00 SF 63. Oak flooring-select grade-no finish 110.00 SF 64. Sand&finish wood floor(natural finish) 6.00 LF 30. R&R Baseboard-5 1/4"w/shoe 96.00 SF 31. R&R 1/2"drywall-hung,taped,with smooth wall finish 96.00 SF 32. Seal the surface area w/latex based stain blocker-one coat 433.17 SF 33. Paint the walls and ceiling-two coats PAUL LAMBERS-ACT 4/3/2012 Page:2 1 Elite Construction 12 Constitutional Blvd Merrimack,N.H 855.Ehte.00 CONTINUED-General DESCRIPTION QNTY 51. Plumber-per hour 8.00 HR Note:Allows for a plumber to make a few separate trips to complete the repairs,Excludes code upgrade that will most likely be required to meet MA State Codes 52. Electrician-per hour 8.00 HR Note:Allows for two separate trips,Excludes code upgrade that will most likely be required to meet MA State Codes 66. Adjusted cost 1.00 EA Grand Total 21,208.16 Frank Tambone Grand Total Areas: 1,320.28 SF Walls 470.78 SF Ceiling 1,791.06 SF Walls and Ceiling 470.78 SF Floor 52.31 SY Flooring 170.67 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 182.50 LF Ceil.Perimeter 470.78 Floor Area 528.58 Total Area 1,320.28 Interior Wall Area 1,218.56 Exterior Wall Area 163.00 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 PAUL_LAMBERS-ACT 4/3/2012 Page:4 MAIN LEVEL -7'11" in Cl 01,1n,Noon ................... Kitctmn io 11 MAIN LEVEL PAUL—LAMBERS-ACT 4/3/2012 Page:6 I i 114" /L--27--+--3T 30.—,' 18" 0" )'-18" " 75" ,V 39" —24" 2"X24" 3 —18" " 47 --1 T J \r W3342 W3018 W1 842-8 _ u N (D ' B24 R 30-RANGE3 B18WB21I CO Nm N N � _ N � II CO 3 °° ' T m CO T 1 r CO ! N r ir W 1 X _L) i a 24.DISHW M VALA42 BE W2142-L - -_ "0ll��l�Il%llllllll/71I�%�lll%I l 34', 1 2'-2 V ),' 3�" 36" A 16 120 48 6" 30" 17416' i 57 6' 42" 1536" I 373"Is 21° 41" 27" t 266" I a 2521" All dimensions-size designations 202015 This is an original design and must Designed:3!7/2012 given are subject to verification on TECHNOLOGIES not be released or copied unless Printed:3/28/2012 job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. I Lambers Kitchen 3 Final-kit 1 All Drawing#: 1 NoScale.