HomeMy WebLinkAboutBuilding Permit #707-2016 - 29 NORMAN ROAD 1/10/2017q, �1 4W � LP BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit No#: (� Date Received
Date Issued:f A�UMPORTANT:
Applicant must complete all items on this page
LOCATION. Z`L
Print��
PROPERTY OWNER R As 1.. *-s.,
rint 100'Year Structure
MAP PARCEL;. ZONING. DISTRICT: Historic District
Machine Shop. Village
O' �ctyeD 'bt Nd
yes
yes �i
yes.
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
q One family
El Addition
❑ Two or more family
❑Industrial
Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
❑,�>=1oo�dn�an � �� VVet�antls,
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DESGRIPI 1UN Uh VVUKP%. I v mr- rr-mrvr% r -u.
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Identification - Please Type or Print Clearly
- Phone:
OWNER: Name: Tit Z� 1 ok l
Address:
Contractor Name: Nnone: cin n yon ii S3 �
Email lC�-�r.:,. �..,.,1 -
Address: R �u�,�r c�•r- �U , q4..�... Ma , v t�-ti'
Supervisor's Constrtaction,, License: U S 1,.U,lL!�; Exp:. Date: .6JZC L'
Home Improvement License: �'a Exp. Date: _.. b.�ZAU% '
ti
ARCHITECT/ENGINEER PNv r..re- � 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: $ cNo 0 0 _FEE: $_S$ H
Check No.: Receipt -No.:
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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 Duimpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
Reviewed On Signature.
Reviewed on Signature
Reviewed on Signature
Zor?ing Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Com
Conservation Decision: Comments
Water & Sewer Connection/Signature &Date Drivewav Permit
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE EPgR�IMENiT� .aT rnp'®urn4p exon site
Fire: Dep�,art�ment sig��ture/ted e���� --
®MMEN�TtS'
Dimension
Number of Stories: Total square feet of floor area',, based on Exterior dimensions.
Total land area, sq. ft.:,
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector yes No
DANGER ZONE LITERATURE. yes ~No
MGL Chapter 166 Section 21A -F and G min.$1oo-$1000 fine
Doc.Building Permit Revised 2014
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, Siding, Interior Rehabilitation Permits
Building Permit Application
Workers Comp Affidavit
Photo Copy Of H.I.C. And/Or C.S.L. Licenses
aCopy of Contract
Floor Plan Or Proposed Interior Work
Engineering Affidavits for Engineered products
ATE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
Building Permit Application
Certified Surveyed Plot Plan
Workers Comp Affidavit
Photo Copy of H.I.C. And C.S.L. Licenses
Copy Of Contract
Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
Mass check Energy Compliance Report (If Applicable)
Engineering Affidavits for Engineered products
TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
Building Permit Application
4. Certified Proposed Plot Plan
4. Photo of H.I.C. And C.S.L. Licenses
,4, Workers Comp Affidavit
Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hvdraulic Calculations (If Applicable)
Copy of Contract
.� 2012 IECC Energy code
Engineering Affidavits for Engineered products
TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit
In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. one copy and proof of recording
must be submitted with the building application
Doc: Building Permit Revised 2014
Location
No. -lb -7- tot Date t 17
Check # 2Z 1
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $�f��E'�
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
LI/I
Building inspector
Enter construction cost for fee cal -
North Andover Fee Calculation
Construction Cost
$ 49,000.00
m
$ -
$
588.00
Plumbing Fee
$
73.50
Gas Fee 100 comm.
$
100.00
Electrical Fee
$
73.50
Total fees collected
$
835.00
29 Norman Road
Kitchen and DR Remodel
707-2017 on 1/10/2017
® DATE(MMIDOYYW)
ACORV CERTIFICATE OF LIABILITY INSURANCE _
12/12/16
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).
PRODUCER CONTACT
PHONE ---Sandi Munroe
M.P. Roberts Insurance Agency — --- -31
_(etc,.N.s._Eat) (978) 683-8073 I WIc,NoL_�978) 6683-3147
1060 Osgood Street AIL
ADDRESS: sandi@mprobertsinsurance.com
North Andover, MA 01845 INSURE S AFFORDING CPV ERAGE, _ NAIL #._..--_-_
INSURER A: Merchants Mutual Insurance Co
INSURED INSURER B: Guard Insurance
KEVIN MURPHY REMODELING INSURER C:
98 FOREST STREET INSURER D:
- _... ..........
NORTH ANDOVER, MA 01845 INSURER E:.._-.
I NSU RER F:
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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 ADDLISUBRI l POLICY EFF I POLICY EXP
LTR I TYPE OF INSURANCE INSR1 WVD I POLICY NUMBER MMIDDNYYY MMIDDIYYYY i LIMITS
A
GENERAL LIABILITY
BOP1068945
11/22/16
11/22/171 , 1,000,000--.- EACHOCCURRENCE $
i— —... -
IX_ COMMERCIAL GENERAL LIABILITY(
DAMAGETO RENTED I
PREM�SE�LEeocGurrQnce) .__SOO,000
CLAIMS{v1ADE OCCUR
�$
ME EXP (Anyorig Pasai) $ — 15 ,000
_
L PERSONAL & ADV INJURY $
--- -- ..- -- ----
GENERAL AGGREGATE $ 2,,000 , 000 .
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I PRODUCTS COMP/OP AGG I $ 2 000.,000
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GEN'LAI — GGREG—'--ATEL--IMITAPPL--- ---
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AUTOMOBILE LIABILITY
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1/23/16
1/23/171 COMBINED SINGLELIMII
(Ea der!) $ 1_,-000,_000...-..
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BODILY INJURY (Per person) T $-
ANYAUTO
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ALLOW<ED SCHEDULED
X
BODILY INJURY (Per accident) ) $
AUTOS
AUTOS NON -OWNED
X HIRED AUTOS X AUTOS
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I PROPERTY DAMAGE
1Peracc:dent) Is
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A
UMBRELLA LIAR
OCCUR
CUP9145304
4 11/22/161
11/22/171 EACH OCCURRENCE $ 1, 000, 000
I EXCESS LIAB
CLAIMS -NIA DEI
j
I :AGGREGATE.,.,, ._ ., i $ 1,000,000
DED RETENTION $
!
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
I
i KEWC726509
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I 7/1/161
7/1/17 WCSTATU-
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L. TOftY LIMITS..
YIN
ANY PROPRIETOR/PARTNER/EXECUTNE
OFFICE RIMEMBER EXCLUDED?
I N I AI
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EL_EACHACCIDENT _j,$. _... 500,000_
(Mandatory in NH)
E.L,_DISEASE,,.-FA.EMPLOYEEI $ 5.00 1000
If yyes, describe under
DESCRIPTIONOFOPERATIONS below
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E.L. DISEASE -POLICY LIMIT $ -500,000
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DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
UtK I It -ILA 1 C MULL/CI[ V WY VCLLH 1 IU 1Y
TOWN OF NORTH ANDOVER
NORTH ANDOVER, MA 01845
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
U TBtSti-ZULU AGUKU GUKI'UKAI IL)N. All rlgnis reserve a.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
Phone: Fax: E -Mail:
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The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street, Suite 100
Boston, MA 02114-2017
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibiy
Name Business/Or tion/Individual •
Address: e i6�
City/State/Zip: �,)v Phone #: VP/
Are you an employe? Check the appropriate box:
1.M l am a employer with employers (full and/or part-time).*
20 I am a sole proprietor or partnership and have no employees working for me in
any capacity. [No workers' comp. insurance required)
301 am a homeowncr doing all work myselL [No workers' comp, insurance required.] t
4.❑ I am a homeowner and will be hiring contractors to coodua all work on my property. I will
ensure that all contractors either have workers' compensation insurance or arc sole
proprietors with no employees.
50 1 am a general contractor and I have hired the sub -contractors listed on the attached sheet.
These sub -contractors have employees and have workers' comp. inanance.S
6.❑ We arc a corporation and its officer's have exercised their right of exemption per MGL c.
152, § 1(41 and we have no employees. [No workers' comp. insurance required.)
Type of project (required):
7. ❑ New construction
8. fg Remodeling
9. ❑ Demolition
10E] Building addition
I LE] Electrical repairs or additions
12. ❑ Plumbing repairs or additions
13.❑Roof repairs
4.[J Other
Any applicant that checks box #] must also fill out the section below showing their workers' compensation policy information
t Homeowners who submit this affidavit indicating they are doing all work and thea hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sb= showing the name of the sub -contractors. and state whether or not those entities have
employees. If the sub -contractors have employees, they must provide their workers comp. policy number.
I am an employer that is providing workers' compensation insurance for my employees Below is the policy and job site
information.
Insurance Company Name: -A re), C, -
Policy # or Self -ins. Lic. #: k,�_ L� L.. C, -1710S-
0 0 Expiration Date: i + l � \�
Job. Site Address: 7.:11k- N �/ V4� City/State/Zip: Nu , ,, e1.w t Mea. 6 . tqj
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to $1,500.00
and/or- one-year imprisonment, as well as civil penalties in the form of a STOP WORK -ORDER and a fine of up to $250.00 a
day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do herebyF certify grader tfie pains and penalties of perjury that the information provided above is true and correct.
Signature: ef�,� --._. ` l Date:
C "—, 11�— b � �- - 5-3
OJWcial 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 S. Plumbing Inspector
6- Other
Contact Person:
Phone #:
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS -053099
Construction Supervisor
i
KEVIN W MURPHIE- s �.
98 FOREST ST r�
I NORTH ANDOVER MA 01845
1
Expiration:
Commissioner 06/29/2017
"• �f76 (l.'Lil)Glllfl7CC(1G'fC��� 6/ ���(ZJ,Ip,!'�CI.JC��i
Office 917 Consumer Affairs & Business Regulation
_ r HOME IMPROVEMENT CONTRACTOR
- Registratiow, ;101874 Type:
Expiration__:.6/29%24]8 Individual
KEVIN MURPHY
Kevin Murphy -
98 FOREST ST.
N. ANDOVER, MA 01845 ZT��
Undersecretary
Kevin Murphy
Building Contractor
To: Greg & Ashley Shea
29 Norman Road
North Andover, Ma 01845
From: Kevin Murphy
CC:
Date: 1/4/2017
.lob: Kitchen
Date of plans: 12/16
Architect: Kitchen designer
Location: Same
Section 1- Work Schedule
98 Forest Street
North Andover, MA 01845
PH: 978-688-6335
FAX: 978-688-7207
All Home improvement Contractors and Subcontractors
engaged in home improvement contracting, unless
specftaly exempt from registration by Provisions of Chapter
142A of the general laws, must be registered with the
Commonwealth of Massachusetts. Inquiries about registration
and Status should be made to the D'rector, Home
Improvement Contract Registration, One Ashburton Place,
Roan 1301, Boston, MA 02108. (617)-727 8598
Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specked here in
writing contractor will begin work on or about 1/15/17.
Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 3/30/17. The owner hereby acknowledges
and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall no be considered as
violations of this agreement.
Section II -Warranty
The Contractor warrants that the work fumished hereunder shall be free from defects in materials and workmanship for a period of 1 year
following completion and shall comply with the requirements of this -Agreement. In the event any defect in workmanship or materials, or
damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job,
including cleanup, the Contractor shall, at his own expense, forthwith remedy, repair correct, replace, or cause to be remedied, repaired, or
replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in
connection with the agreed-upon work.
Section 111- Scope of Work
General
Page 1 of 4
Kevin Murphy
°r Building Contractor
98 Forest Street
North Andover, MA 01845
PH: 9786885335
FAX 97868&7207
Page 2 of 4
Proposal is to renovate existing kitchen, study, and dining area. Plans to be provided by owner. Building permit
to be obtained by contractor.
Demolition
Existing study, small working kitchen area, and dining room will be completely gutted. Wall between kitchen and
office will be removed. Wall between dining room and living room, will be partially removed. Chimney will be
removed. Asbestos siding on kitchen wall will be removed and disposed of.
Building
All frame and siding materials to renovate kitchen, open up walls, and install new window will be provided. One
new Harvey twin casement window will be supplied and installed as shown on plans.
Plumbing
Plumbing required to relocate kitchen sink will be provided. Sink / faucet to be provided by owner. Other
plumbing required to install kitchen appliances will be provided.
Electrical
Electrical work required to wire kitchen to code will be provided. Eight recessed lights have been included.
Surface mounted fixtures to be supplied by owner ( under cabinet lights, ceiling fan, pendants ) installed by
contractor. General layout to be approved by owner, prior to rough. Sub panel will be installed as required.
Heating/Air Conditioning
Existing heating will be relocated as required.
Insulation
Exterior walls will be insulated to meet code.
Plaster
New kitchen area, and all disturbed areas, will be blueboarded and skimcoat plastered. Walls will be smooth,
ceilings to match existing.
Interior Trim/Doors
Interior trim will be supplied and installed to match existing. Kitchen cabinets to be supplied by owner, installed
by contractor. Countertops to be supplied / installed by vendor.
Painting
All interior and exterior painting will be provided.One coat of primer, and two coats of finish will be applied to all
painted surfaces.
Flooring
Kevin Murphy Page 3 of 4
Building Contractor
98 Forest Street
North Andover, AAA 01845
PH: 9786885335
FAX 9788887207
Pre -finished hardwood floors will be supplied and installed in new kitchen, and renovated dining area. An
allowance of $5 per square foot has been included for flooring material.
Waste Removal
All demolition / construction debris will be disposed of by contractor.
'�S
M • • 1
l
Kevin Murphy
Building Contractor
98 Forest Street
Nath Andover, MA 01845
PH: 9786885335
FAX 978688-7207
Section IV - Price Schedule
Total
We hereby propose to furnish material and labor — complete
in Accordance with above specifications for the sum of .... • • • • • • • • • . • • • • • • • . • • • • • • • • • • • • • • • $49,000
Payment to be made as follows:
Page 4 of 4
Percenta a/ltem
Description
Amount
1
Permit obtained
$2500
2
Demolition complete
$7500
3
Rough plumbing / electric complete
$10,000
4
Plastering complete
$8000
5
Trim / cabinets installed
$10,000
6
Paint / floors complete
$6000
7
Job 100% complete
$5000
7
1$49,000.00
—Notice: No agreement for Home improvement contracting work shall require a down payment (advance deposit) of more that one-third of the total contract price of the total amount of all deposits or
payments which the contractor must make, in advance, to order andror otherwise obtain delivery of special order materials and equipment, whichever is greater
Contractor: Kevin Murphy
98 Forest Street
No. Andover, MA
M RAR
Section V — Acceptance
Acceptance of Proposal — I have read this document and accept the prices, specifications, and conditions stated.
understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified.
Payment will be made as outlined above.
You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this
transaction cancellation must be done in writing
DO NOT SIGN THIS NTRACT IF THERE ARE ANY BLANK SPACES
Signature 66�4 C_.` Date
Signature Date