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HomeMy WebLinkAboutBuilding Permit #436-13 - 209 JOHNSON STREET 11/30/2012 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received I v Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION' c1 J o�AV\S cz:,v\ Print PROPERTY OWNER CsN1A< 14o g, C, qvp- 'Print 100 Year Old Structure_ yes (noMAPNO: PARCEL ZONING DISTRICT: Historic District yesMachine Shop Village yes. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building WOne family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: 14 Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District 11 Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: C l eC, -�- Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: S-2.N Qfn O-C 64%one."Z06JQ:)g�' Address: ?mak Supervisor's Construction License:C S bb" 6`tn Exp. Home Improvement License: LS-a2P ( Exp. Date: 3( L 3 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: $ L4, 3 a-O FEE: $ Check No.: !Ss n�)� Receipt No.:acc_ NOTE: Persons contracting with unregistered contractors do not have 0=o the guaronty fund Signature of Agent/Owner Signature of contrac or Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature "COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes I Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Tow.- Engineer: Signature: Located 384 Os ood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at"124.Main1Street Fire Department,signature/date i 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.$10041000 fine NOTES and DATA— For department use U Notified for pickup - Date I Doc.Building Permit Revised 2010 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 u Building Permit Application U Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses u Copy of Contract u Floor Plan Or Proposed Interior Work . . . a .Engineering Affidavits for.Engineered.products.. NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application Li Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses u Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New ConstructionSin le and Two Family) � 9 Y) Li Building Permit Application u Certified Proposed -Plot Plan Li Photo of H.I.C. And C.S.L. Licenses u Workers Comp Affidavit u Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) u Copy of Contract o Mass check Energy Compliance Report u 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: Doc.Building Permit Revised 2012 Locatio [/ y No. Date ` TOWN OF NORTH AN,OOVER o Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL � � Check# S 25998 Building Inspector r - .r 1 1 NORTH - : �. .c . . ver No. I t - _ h0 0".L.-. ver, Mass, A- *9—a coc.4ic"IWICK �1' 7� A�R�TEO PPa,��� S V BOARD OF HEALTH PERMI� T T LD Food/Kitchen i Septic System THIS CERTIFIES THAT0."04 + BUILDING INSPECTOR .... ............................. ... ........... ...... .. .. . .. .. .1&$ Od�a�� Foundation has permission to ere ......................... buildings on . .............. "' . ........................... .......... Rough to be occupied as ....�... ... . ,� ...... ..... .. ............... ... . ... ............... Chimney ct conform to the terms e a lication provided that the person accepting this permit shall in every respect pp 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTH ELECTRICAL INSPECTOR UNLESS CONSTRU, IAR S Rough +�a.... _ Service .......... . ........ ........ ........... ................................ Final BUILDING INSPECTOR I 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. SEE REVERSE SIDE ACORVCERTIFICATE OF LIABILITY I DIDD INSURANCE 111/13/13/2001212 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, !MPO TANT: 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). PRODUCER ACT NAME: Linda Bogdas).owicz INSURANCE SOLUTIONS CORPORATION PHONE . (603)382-4600 FAX (603)382-2034 60 Westville Rd EMAIL lindab@iscinsures.Com INSURE S AFFORDING COVERAGE NAIC N Plaistow W NH 03865 INSURERA:Safet Insurance INSURED INSURER B:Chartis KeJo Corporation dba Servpro of Lawrence INSURER G: 8 Blakelin Street INSURER D: INSURER E Lawrence MA 01841 INSURER COVERAGES CERTIFICATE NUMBER:CL1292507044 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. 0LTR 4SR I TYPE OF INSURANCE DD UB POLICY EFF POLICY EXP LIMITS POLICY NUMBER GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMAGE TUTMWrMF- PREMISESn E CLAIMS4 ADE F7 OCCUR MED EXP(Any one person) $ GENERAL ERSONAL 8 ADV INJURY $ AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: RODUCTS-COMPIOP AGG S 17 POLICY PRO- LOC $ AUTOMOBILE LIABILITYANY AUTO (Ea accident)SINGLE LIMB 1 000 000 A ALL OWNED SCHEDULED 6214923 BODILY INJURY(Per person) $ AUTOS AUTOS 0/1/2012 0/1/2013 BODILY INJURY(per accident) $ X HIRED AUTOS X NON-OWNEO PROPERTY DAMA AUTOS $ accident) Uninsured motorist 31 s 181"Imit $ 500,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS,LIABILITY Limils ER ANY PROPRIETORIPARTNERIEXECUTIVE Y/N OFFICERIMEMBEREXCLUDED? NIA E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) 001609671 /1/2012 /1/2013 If E.L.DISEASE-FA EMPLOYE S 1,000,000 yes,de6tnbe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S 11000.000 B Pollution X CPL15829477 /1/2012 /1/2013 g100()DDOEach Ocoxence S2,OM.ODO Aggregate . DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,K more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Remax Prestige ACCORDANCE WITH THE POLICY PROVISIONS. attn Derick Amato 209 Johnson St AUTHORIZED REPRESENTATIVE North Andover, MA 01845-4603 Keith Maglia/CLS ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201oos).O1 The ACORD name and logo are registered marks of ACORD WHITKE1 OP ID: PI ACC�RO" DATE(MMIDDlYYYY) CERTIFICATE OF LIABILITY INSURANCE 11113112 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). PRODUCER Phone:608-788-6160 CONTACT Stanley McDonald Agency IL Inc NAME: 2018 State Road P.O.Box 1446 Fax:608-788-7012 ac°NN Ext arc No LaCrosse,WI 54602-1446 ADDRL James R.Mc Donald INSURER(S)AFFORDING COVERAGE NAIC M INSURERA.Tudor Insurance company 37982 dba Servpro of Lawrence INSURED Corporation INSURER B:Travelers Property Casualty 25674 ba See Note For Named Insured INSURER C: PO Box 328 INSURER D: Lawrence,MA 01842 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. /NSRADM S LTR TYPE OF INSURANCEINSR WUB POLICY NUMBER MMIDDIYYYY MMlDDlYYYY LIMITS GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY PGP0759010 03/01/12 03/01/13 PREM SES Ea LN I ED occurrence $ 300,000 CLAIMS MADE I OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY JECT PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ 4UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION$ WORKERS COMPENSATION WC�QR STALifTU- OTH- AND EMPLOYERS'LIABILITY T I ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y!N OFFICERIMEMBER EXCLUDED? ❑ N r A E.L.EACH ACCIDENT $ (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Property Section 7107P412 03/01/12 03/01113 675,000 B EmployeeDishonesty 7107P412 03/01/12 03/01/13 25,000 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION REMAPR3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Remax Prestige ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Derick Amato 209 Johnson Street AUTHORIZED REPRESENTATIVE North Andover, MA 01845-4603 4 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD INOTEPADWHITKEI PAGE 2 INSURED'S NAME KeJo Corporation OP ID: PI DATE 11/13112 Named Insured: eJo Corporation dba Servpro of Lawrence dba Servpro of Lawrence-Three dba Servpro of Lawrence-Two dba Servpro of Salem/Plaistow dba Servpro of The dovers. t i Office�f o1 mer W,irs 2 en ss eg� License or registration valid for individul use only j HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: ,;:158271 Type: Office of Consumer Affairs and Business Regulation Private Corporation p 10 Park Plaza-Suite 5170 Expiration 1,2!3.1/2013 Boston,MA 02116 K CORPORATION � x , I SERVPRO OF LAWRECE,'fT A�S. GREGG WHITE r` 8 BLAKELIN STREET'' LAWRENCE,MA 01841 Undersecretary . ithout ure Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-067690 GREGG M WHIT 4 CHATBURN Rlfr ~ WMRAM NH 03087 f 951+-� Expiration Commissioner 02/20/2014 � t I Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet (991M )of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS I 3 I u it I GMAC. Mortgage Repair Work Authorization ("Contract") This form is to be faxed to the Contractor, Listing Agent,and GMAC Asset Manager CAMILLE BAKER simultaneously by an GMAC representative. Upon execution,the Contractor will return a faxed copy to all properties. GMAC Account Number: 0599167509 Property Address: 209 JOHNSON STREET NORTH ANDOVEI MA 01845 Pre Marketing Specialist: RONDA BOOTH Phone: 2148742893 Fax: Team Manager: SARA MUNDELL Phone: Fax: Contractor: SERVPRO Phone: Fax: Contractor Payee No: CC: Listing Agent: DEREK AMATO Phone: 9787715159 Fax:9782154550 CC: GMAC Asset Mgr: CAMILLE BAKER Phone: 2148746978 Fax: Authorization: GMAC Representative's Signature: CAMILLE BAKER Date: 10/29/12 Contractor's Signature: Date: (I IS- 1 'a. Contractor X AGENT r VENDOR Notes: Contract Agreement ("Contract") GMAC accepts the bid dated 10/29/12 by SERVPRO for$9431.62 The contractor shall complete all work by-44*60"+" _("completion date"). If the work is not done by the completion date, GM C may charge the contractor$.00001 per day("late fee")until the work is complete.The late fee is to compensate GMAC for additional holding costs incurred due to unreasonable construction delays. GMAC may cancel the contract in addition to charging late fees beginning the day after the contract completion date, if in the discretion of GMAC the work cannot be completed timely. Late fees will continue to accumulate until the work is complete. In this circumstance, GMAC has the right to have another contractor bid and complete the work authorization above.The contractor from this original contract will be paid any balance left after late fees have been deducted and the new contractor has been paid in full. In the event the contract is canceled,this Contract will act as a waiver of lien.The contractor hereby waives and releases any mechanics or materialman's lien, or claim of right of such lien,on these premises and improvements. Invoice must be received at GMAC no later than 20 days after the closing of sale for the property. Invoices received after this date will be denied. Job Sign Offs and Invoicing Instructions: The agent should make inspections of the property during the repair process, and provide a final punch list of items to the contractor upon initial job completion.The repair job is not complete until all final punch list items are corrected.Agents should wait for work to be complete before submitting a punch list to the contractor.Agents should attempt to get everything on one list to limit the number of times the contractor has to return to the property. GMAC Approved Contractors are responsible for filling out all invoicing and submitting photos to GMAC for payment. Agent's must sign off on the Payment Request Form and return it to the contractor. SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 Client: Amato,Derek Home: (978)771-5159 Property: 209 Johnson Street N.Andover,MA 01845 i Operator Info: Operator: WHITE Estimator: White,Brian Business: (978)688-2242 x 13 E-mail: bwhite@servprooflawrence. com Business: PO Box 328 Lawrence,MA 01842 Type of Estimate: MOLD Date Entered: 9/18/2012 Date Assigned: Price List: MAEM7X SEP12 Labor Efficiency: Restoration/Service/Remodel Estimate: 2012-09-18-1231 SERVPRO@ Fire&Water-Cleanup&RestorationTM Like it never even happened. •Iil SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 2012-09-18-1231 Main Level Bedroom Height: 8' t 520.00 SF Walls 214.35 SF Ceiling 734.35 SF Walls&Ceiling 214.35 SF Floor ' 23.82 SY Flooring 65.00 LF Floor Perimeter 65.00 LF Ceil.Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out trim and bag for disposal 65.00 LF 0.71 46.15 (0.00) 46.15 Tear out wet drywall,cleanup,bag,per 65.00 LF 3.65 237.25 (0.00) 237.25 LF-up to 4'tall Tear out and bag wet insulation 195.00 SF 0.53 103.35 (0.00) 103.35 HEPA Vacuuming-hourly charge 2.00 HR 46.96 93.92 (0.00) 93.92 Water extraction from floor 214.35 SF 0.45 96.46 (0.00) 96.46 Tear out wet non-salvageable carpet, 214.35 SF 0.40 85.74 (0.00) 85.74 cut&bag for disp. Tear out wet carpet pad and bag for 214.35 SF 0.36 77.17 (0.00) 77.17 disposal Clean the floor with pressure steam 214.35 SF 0.75 160.76 (0.00) 160.76 Apply plant-based anti-microbial agent 948.71 SF 0.20 189.74 (0.00) 189.74 Remove Interior door-birch-slab 1.00 EA 6.90 6.90 (0.00) 6.90 only Totals: Bedroom 1,097.44 0.00 1,097.44 F 3'2° sg,,,,,,, Bdrm Closet Height:8' r U' 218.67 SF Walls 34.71 SF Ceiling m 253.38 SF Walls&Ceiling 34.71 SF Floor io b 3.86 SY Flooring 27.33 LF Floor Perimeter a6 3 1 27.33 LF Ceil. Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out trim and bag for disposal 27.33 LF 0.71 19.40 (0.00) 19.40 Tear out wet drywall,cleanup,bag,per 27.33 LF 3.65 99.75 (0.00) 99.75 LF-up to 4'tall Tear out and bag wet insulation 82.00 SF 0.53 43.46 (0.00) 43.46 2012-09-18-1231 11/12/2012 Page:2 SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 CONTINUED-Bdrm Closet DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV HEPA Vacuuming-hourly charge 0.50 HR 46.96 23.48 (0.00) 23.48 Water extraction from floor 34.71 SF 0.45 15.62 (0.00) 15.62 Tear out wet non-salvageable carpet, 34.71 SF 0.40 13.88 (0.00) 13.88 cut&bag for disp. Tear out wet carpet pad and bag for 34.71 SF 0.36 12.50 (0.00) 12.50 disposal Clean the floor with pressure steam 34.71 SF 0.75 26.03 (0.00) 26.03 Apply plant-based anti-microbial agent 288.08 SF 0.20 57.62 (0.00) 57.62 Remove Interior door-birch-slab 1.00 EA 6.90 6.90 (0.00) 6.90 only Totals: Bdrm Closet 318.64 0.00 318.64 Bathroom Height: 8' 256.00 SF Walls 63.75 SF Ceiling �m 319.75 SF Walls&Ceiling 63.75 SF Floor 7.08 SY Flooring 32.00 LF Floor Perimeter X1 1 '6'I t6 32.00 LF Ceil.Perimeter 3' '2" DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out trim and bag for disposal 32.00 LF 0.71 22.72 (0.00) 22.72 Tear out wet drywall,cleanup,bag,per 32.00 LF 3.65 116.80 (0.00) 116.80 LF-up to 4'tall Tear out and bag wet insulation 96.00 SF 0.53 50.88 (0.00) 50.88 HEPA Vacuuming-hourly charge 0.50 HR 46.96 23.48 (0.00) 23.48 Water extraction from floor 63.75 SF 0.45 28.69 (0.00) 28.69 Clean the floor with pressure steam 63.75 SF 0.75 47.81 (0.00) 47.81 Apply plant-based anti-microbial agent 383.50 SF 0.20 76.70 (0.00) 76.70 Remove Interior door-birch-slab 1.00 EA 6.90 6.90 (0.00) 6.90 only Totals: Bathroom 373.98 0.00 373.98 2012-09-18-1231 11/12/2012 Page: 3 SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 Height: 8' Living Room Hei ,y g j 823.54 SF Walls 413.80 SF Ceiling 1237.34 SF Walls&Ceiling 413.80 SF Floor r� � ll 45.98 SY Flooring 102.94 LF Floor Perimeter T 102.94 LF Ceil.Perimeter t DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out trim and bag for disposal 102.94 LF 0.71 73.09 (0.00) 73.09 Tear out wet drywall,cleanup,bag,per 102.94 LF 3.65 375.73 (0.00) 375.73 LF-up to 4'tall Tear out and bag wet insulation 308.83 SF 0.53 163.68 (0.00) 163.68 HEPA Vacuuming-hourly charge 3.00 HR 46.96 140.88 (0.00) 140.88 Water extraction from floor 413.80 SF 0.45 186.21 (0.00) 186.21 Tear out wet non-salvageable carpet, 413.80 SF 0.40 165.52 (0.00) 165.52 cut&bag for disp. Tear out wet carpet pad and bag for 413.80 SF 0.36 148.97 (0.00) 148.97 disposal Clean the floor with pressure steam 413.80 SF 0.75 310.35 (0.00) 310.35 Apply plant-based anti-microbial agent 1,651.14 SF 0.20 330.23 (0.00) 330.23 Remove Interior door-birch-slab 1.00 EA 6.90 6.90 (0.00) 6.90 only Totals: Living Room 1,901.56 0.00 1,901.56 h.��dc Living Closet Height: 8' 132.00 SF Walls 12.85 SF Ceiling 144.85 SF Walls&Ceiling 12.85 SF Floor 1i'1.2j 1.43 SY Flooring 16.50 LF Floor Perimeter 16.50 LF Ceil.Perimeter F2'T'i DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out trim and bag for disposal 16.50 LF 0.71 11.72 (0.00) 11.72 Tear out wet drywall,cleanup,bag,per 16.50 LF 3.65 60.23 (0.00) 60.23 LF-up to 4'tall Tear out and bag wet insulation 49.50 SF 0.53 26.24 (0.00) 26.24 HEPA Vacuuming-hourly charge 0.25 HR 46.96 11.74 (0.00) 11.74 Water extraction from floor 12.85 SF 0.45 5.78 (0.00) 5.78 2012-09-18-1231 11/12/2012 Page:4 l SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 CONTINUED-Living Closet DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out wet non-salvageable carpet, 12.85 SF 0.40 5.14 (0.00) 5.14 cut&bag for disp. Tear out wet carpet pad and bag for 12.85 SF 0.36 4.63 (0.00) 4.63 disposal Clean the floor with pressure steam 12.85 SF 0.75 9.64 (0.00) 9.64 Apply plant-based anti-microbial agent 157.69 SF 0.20 31.54 (0.00) 31.54 Remove Interior door-birch-slab 1.00 EA 6.90 6.90 (0.00) 6.90 only Totals: Living Closet 173.56 0.00 173.56 Bedroom 2 Height: 8' 568.00 SF Walls 259.67 SF Ceiling 4 4 h 827.67 SF Walls&Ceiling 259.67 SF Floor 28.85 SY Flooring 71.00 LF Floor Perimeter 71.00 LF Ceil.Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out trim and bag for disposal 71.00 LF 0.71 50.41 (0.00) 50.41 Tear out wet drywall,cleanup,bag,per 71.00 LF 3.65 259.15 (0.00) 259.15 LF-up to 4'tall Tear out and bag wet insulation 213.00 SF 0.53 112.89 (0.00) 112.89 HEPA Vacuuming-hourly charge 2.00 HR 46.96 93.92 (0.00) 93.92 Water extraction from floor 259.67 SF 0.45 116.85 (0.00) 116.85 Tear out wet non-salvageable carpet, 259.67 SF 0.40 103.87 (0.00) 103.87 cut&bag for disp. Tear out wet carpet pad and bag for 259.67 SF 0.36 93.48 (0.00) 93.48 disposal Clean the floor with pressure steam 259.67 SF 0.75 194.75 (0.00) 194.75 Apply plant-based anti-microbial agent 1,087.33 SF 0.20 217.47 (0.00) 217.47 Remove Interior door-birch-slab 1.00 EA 6.90 6.90 (0.00) 6.90 only Totals: Bedroom 2 1,249.69 0.00 1,249.69 2012-09-18-1231 11/12/2012 Page: 5 - SERVPRO of Lawrence PO Box 328 Lawrence MA 01842 800 535-6322 Tax Id#02-0353691 Bdrm 2 Closet 2 Height:8' 128.00 SF Walls 12.00 SF Ceiling i 140.00 SF Walls&Ceiling 12.00 SF Floor 8., 1.33 SY Flooring 16.00 LF Floor Perimeter 16.00 LF Ceil.Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out trim and ba for disposal 16.00 LF g p 0.71 11.36 (0.00) 11.36 Tear out wet drywall,cleanup,bag,per 16.00 LF 3.65 58.40 (0.00) 58.40 LF-up to 4'tall Tear out and bag wet insulation 48.00 SF 0.53 25.44 (0.00) 25.44 HEPA Vacuuming-hourly charge 0.25 HR 46.96 11.740.00 ( ) 11.74 Water extraction from floor 12.00 SF 0.45 5.40 (0.00) 5.40 Tear out wet non-salvageable carpet, 12.00 SF 0.40 4.80 (0.00) 4.80 cut&bag for disp. Tear out wet carpet pad and bag for 12.00 SF 0.36 4.32 (0.00) 4.32 disposal Clean the floor with pressure steam 12.00 SF 0.75 9.00 (0.00) 9.00 Apply plant-based anti-microbial agent 152.00 SF 0.20 30.40 (0.00) 30.40 Remove Interior door-birch-slab 1.00 EA 6.90 6.90 (0.00) 6.90 only Totals: Bdrm 2 Closet 2 167.76 0.00 167.76 s. Bdrm 2 Closet Height:8' z' T T 80.00 SF Walls 6.00 SF Ceiling 2< < 86.00 SF Walls&Ceiling 6.00 SF Floor 1 0.67 SY Flooring 10.00 LF Floor Perimeter t247 co 10.00 LF Ceil.Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out trim and bag for disposal 10.00 LF 0.71 7.10 (0.00) 7.10 Tear out wet drywall,cleanup,bag, per 10.00 LF 3.65 36.50 (0.00) 36.50 LF-up to 4'tall Tear out and bag wet insulation 30.00 SF 0.53 15.90 (0.00) 15.90 HEPA Vacuuming-hourly charge 0.25 HR 46.96 11.74 (0.00) 11.74 Water extraction from floor 6.00 SF 0.45 2.70 (0.00) 2.70 2012-09-18-1231 11/12/2012 Page: 6 mu ,=- SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 CONTINUED-Bdrm 2 Closet DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Tear out wet non-salvageable carpet, 6.00 SF 0.40 2.40 (0.00) 2.40 cut&bag for disp. Tear out wet carpet pad and bag for 6.00 SF 0.36 2.16 (0.00) 2.16 disposal Clean the floor with pressure steam 6.00 SF 0.75 4.50 (0.00) 4.50 Apply plant-based anti-microbial agent 92.00 SF 0.20 18.40 (0.00) 18.40 Remove Interior door-birch-slab 1.00 EA 6.90 6.90 (0.00) 6.90 only Totals: Bdrm 2 Closet 108.30 0.00 108.30 Unfinished Height: 8' 1 r ` 1 618.30 SF Walls 180.52 SF Ceiling 798.82 SF Walls&Ceiling 180.52 SF Floor 20.06 SY Flooring 77.29 LF Floor Perimeter 77.29 LF Ceil.Perimeter Missing Wall 3'6"X 8' Opens into HALLWAY DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV HEPA Vacuuming-hourly charge 1.00 HR 46.96 46.96 (0.00) 46.96 Apply plant-based anti-microbial agent 979.34 SF 0.20 195.87 (0.00) 195.87 Clean floor 180.52 SF 0.32 57.77 (0.00) 57.77 Totals: Unfinished 300.60 0.00 300.60 2012-09-18-1231 11/12/2012 Page:7 i • - SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 i Tax Id#02-0353691 i Hallway Height:8' b i re 1 390.67 SF Walls 77.96 SF Ceiling I-r' 468.63 SF Walls&Ceiling 77.96 SF Floor 8.66 SY Flooring 48.83 LF Floor Perimeter 48.83 LF Ceil.Perimeter Missing Wall 3'6" X 8' Opens into UNFINISHED DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV HEPA Vacuuming-hourly charge 1.00 HR 46.96 46.96 (0.00) 46.96 Apply plant-based anti-microbial agent 546.58 SF 0.20 109.32 (0.00) 109.32 Clean floor 77.96 SF 0.32 24.95 (0.00) 24.95 Totals: Hallway 181.23 0.00 181.23 -; Kitchen Height:8' 439.78 SF Walls 196.86 SF Ceiling 636.64 SF Walls&Ceiling 196.86 SF Floor � G 21.87 SY Flooring 54.00 LF Floor Perimeter ? 59.83 LF Ceil.Perimeter rr +•r Missing Wall-Goes to Floor 2' 11" X 618" Opens into ROOMl Missing Wall-Goes to Floor 2' 11" X 61811 Opens into Exterior DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Negative air fan/Air scrubber(24 hr 1.00 DA 71.30 71.30 (0.00) 71.30 period)-No monit. Containment Barrier/Airlock/Decon. 100.00 SF 0.57 57.00 (0.00) 57.00 Chamber Hazardous Waste/Mold Cleaning 2.00 HR 62.86 125.72 (0.00) 125.72 Technician-per hour HEPA Vacuuming-hourly charge 0.50 HR 46.96 23.48 (0.00) 23.48 Clean floor 196.86 SF 0.32 63.00 (0.00) 63.00 Apply plant-based anti-microbial agent 196.86 SF 0.20 39.37 (0.00) 39.37 All work in this area to be performed with source containment. Totals: Kitchen 379.87 0.00 379.87 2012-09-18-1231 11/12/2012 Page: 8 1 -a� - --• SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 I-4 e^ Hallwayl Height:8' 188.56 SF Walls 36.00 SF Ceiling ,� "T 224.56 SF Walls&Ceiling 36.00 SF Floor 1 €, Z� 4.00 SY Flooring 23.08 LF Floor Perimeter �n in latchm 4'14 1 26.00 LF Ceil. Perimeter 4.4• Missing Wall-Goes to Floor 2' 11"X 6'8" Opens into KITCHEN DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV i Negative air fan/Air scrubber(24 hr 0.50 DA 71.30 35.65 (0.00) 35.65 period)-No monit. Containment Barrier/Airlock/Decon. 60.00 SF 0.57 34.20 (0.00) 34.20 Chamber Hazardous Waste/Mold Cleaning 1.00 HR 62.86 62.86 (0.00) 62.86 Technician-per hour HEPA Vacuuming-hourly charge 0.25 HR 46.96 11.74 (0.00) 11.74 Clean floor 36.00 SF 0.32 11.52 (0.00) 11.52 Apply plant-based anti-microbial agent 36.00 SF 0.20 7.20 (0.00) 7.20 All work in this area to be performed with source containment. Totals: Hallwayl 163.17 0.00 163.17 ,-5* ,-5Library Height: 8' 435.25 SF Walls 184.20 SF Ceiling 619.45 SF Walls&Ceiling 184.20 SF Floor a 20.47 SY Flooring 54.41 LF Floor Perimeter 54.41 LF Ceil.Perimeter vsr � DESCRIPTION QUANTITY UNIT COST RCV DEPR EC. ACV Negative air fan/Air scrubber(24 hr 0.50 DA 71.30 35.65 (0.00) 35.65 period)-No monit. Containment Barrier/Airlock/Decon. 80.00 SF 0.57 45.60 (0.00) 45.60 Chamber Hazardous Waste/Mold Cleaning 1.50 HR 62.86 94.29 (0.00) 94.29 Technician-per hour HEPA Vacuuming-hourly charge 0.50 HR 46.96 23.48 (0.00) 23.48 Clean floor 184.20 SF 0.32 58.94 (0.00) 58.94 Apply plant-based anti-microbial agent 184.20 SF 0.20 36.84 (0.00) 36.84 All work in this area to be performed with source containment. 2012-09-18-1231 11/12/2012 Page:9 -1 _1� SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 I CONTINUED-Library DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV I Totals: Library 294.80 0.00 294.80 F--5'2"--V 51-5'--1'4*' Bathroom Height:8' 4'8" TV T 380.53 SF Walls 72.70 SF Ceiling eFe--8 453.24 SF Walls&Ceiling 72.70 SF Floor 6"I Bathroom •6„I 1 8.08 SY Flooring 47.57 LF Floor Perimeter 11 10" 11 5" 47.57 LF Ceil.Perimeter i DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Negative air fan/Air scrubber(24 hr 1.00 DA 71.30 71.30 (0.00) 71.30 period)-No monit. Containment Barrier/Airlock/Decon. 64.00 SF 0.57 36.48 (0.00) 36.48 Chamber Hazardous Waste/Mold Cleaning 2.00 HR 62.86 125.72 (0.00) 125.72 Technician-per hour HEPA Vacuuming-hourly charge 1.00 HR 46.96 46.96 (0.00) 46.96 Clean floor 72.70 SF 0.32 23.26 (0.00) 23.26 Clean bathroom fixtures 1.00 EA 69.04 69.04 (0.00) 69.04 Apply plant-based anti-microbial agent 72.70 SF 0.20 14.54 (0.00) 14.54 All work in this area to be performed with source containment. Totals: Bathroom 387.30 0.00 387.30 t Master Bedroom Height: 8' 652.16 SF Walls 312.47 SF Ceiling �_. 964.62 SF Walls&Ceiling 312.47 SF Floor T = = 34.72 SY Flooring g 81.52 LF Floor Perimeter 81.52 LF Ceil.Perimeter 2012-09-18-1231 11/12/2012 Page: 10 i -igtll - SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Negative air fan/Air scrubber(24 hr 1.00 DA 71.30 71.30 (0.00) 71.30 period)-No monit. Containment Barrier/Airlock/Decon. 100.00 SF 0.57 57.00 (0.00) 57.00 Chamber Hazardous Waste/Mold Cleaning 2.00 HR 62.86 125.72 (0.00) 125.72 Technician-per hour HEPA Vacuuming-hourly charge 0.50 HR 46.96 23.48 (0.00) 23.48 Clean floor 31.2.47 SF 0.32 99.99 (0.00) 99.99 Apply plant-based anti-microbial agent 312.47 SF 0.20 62.49 (0.00) 62.49 All work in this area to be performed with source containment. Totals: Master Bedroom 439.98 0.00 439.98 Total: Main Level 7,537.88 0.00 7,537.88 Job DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV Dumpster load-Approx.30 yards,5-7 1.00 EA 790.00 790.00 (0.00) 790.00 tons of debris Equipment setup,take down,and 2.00 HR 43.83 87.66 (0.00) 87.66 monitoring(hourly charge) Containment Barrier/Airlock/Decon. 64.00 SF 0.57 36.48 (0.00) 36.48 Chamber Hazardous Waste/Mold Cleaning 3.00 HR 62.86 188.58 (0.00) 188.58 Technician-per hour Remove content debris to dumpster Add for personal protective equipment 30.00 EA 8.67 260.10 (0.00) 260.10 (hazardous cleanup) Neg.air fan/Air scrub.-Large(per 24 4.00 DA 111.43 445.72 (0.00) 445.72 hr period)-No monit. Totals: Job 1,808.54 0.00 1,808.54 Line Item Totals: 2012-09-18-1231 9,346.42 0.00 9,346.42 2012-09-18-1231 11/12/2012 Page: 11 i SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 Grand Total Areas: 5,831.44 SF Walls 2,077.84 SF Ceiling 7,909.28 SF Walls and Ceiling 2,077.84 SF Floor 230.87 SY Flooring 727.47 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 736.22 LF Ceil.Perimeter 2,077.84 Floor Area 2,273.72 Total Area 6,005.22 Interior Wall Area 3,878.39 Exterior Wall Area 433.09 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 2012-09-18-1231 11/12/2012 Page: 12 --- SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Taxld#02-0353691 Summary Line Item Total 9,346.42 Material Sales Tax @ 6.250% x 1,363.15 85.20 Replacement Cost Value $9,431.62 Net Claim $9,431.62 White,Brian 2012-09-18-1231 11/12/2012 Page: 13 I - SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 i Tax Id#02-0353691 Recap by Room Estimate:2012-09-18-1231 Area: Main Level Bedroom 1,097.44 11.74% Bdrm Closet 318.64 3.41% Bathroom 373.98 4.00% Living Room 1,901.56 20.35% Living Closet 173.56 1.86% Bedroom 2 1,249.69 13.37% Bdrm 2 Closet 2 167.76 1.79% Bdrm 2 Closet 108.30 1.16% Unfinished 300.60 3.22% Hallway 181.23 1.94% Kitchen 379.87 4.06% Hallwayl 163.17 1.75% Library 294.80 3.15% Bathroom 387.30 4.14% Master Bedroom 439.98 4.71% Area Subtotal: Main Level 7,537.88 80.65% Job 1,808.54 19.35% Subtotal of Areas 9,346.42 100.00% Total 9,346.42 100.00% i 2012-09-18-1231 11/12/2012 Page: 14 i i - - SERVPRO of Lawrence PO Box 328 Lawrence,MA 01842 800 535-6322 Tax Id#02-0353691 Recap by Category Items Total % CLEANING 1,171.31 12.42% GENERAL DEMOLITION 3,597.38 38.14% LABOR ONLY 722.89 7.66% WATER EXTRACTION&REMEDIATION 3,854.84 40.87% Subtotal 9,346.42 99.10% Material Sales Tax @ 6.250% 85.20 0.90% Total 9,431.62 100.00% 1 , 2012-09-18-1231 11/12/2012 Page: 15 I i i Main Level f t i F— 4v r T tYa- � h IT 7' m ij 3 1 T6 �- ,Iii- , m,• cath m m m „r ti ror, b t-0'I'-• m m sotb— ,rr s•r \bg. T5i 1-77 5 � T i~ eeQroee,] 14- I _ m 1 2V IT 156' s—i 1F—r T 1411` 13'6' („ f—s Y Sb IG 4'r F T —i 4''i [tarter eedrao„t Ubam T m & F 2' 1 1 Isr i I' G Main Level 2012-09-18-1231 11/12/2012 Page: 16