Loading...
HomeMy WebLinkAboutBuilding Permit #399-15 - 295 MAIN STREET 10/28/2014 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page x t- D Print ,� ,PROPERTY�OWNER Jt��.NN � rer� (' rro Al Pring n 1OO Year Old Structure yes ;no dMAP NO , PARCEL ®3` ZONING RISTRiGT Histone District eeShopxillage yes TYPE OF IMPROVEMENT. PROPOSED USE Residential Non- Residential ❑ New Building 6One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑.Septic' ❑WeH n ❑ Floodplain` a etlagds " ❑. V1/atershetljD stnct DESCRIPTION OF WORK TO BE PERFORMED: 2 e h vim- -r"'o Nr o..i k�Z_o D w.s i►mss ,\\ ,�\�c��,.�,,..r— Identification Please Type or Print Clearly) OWNER: Name: r-Jce"-n..A..d l\ Phone: q'i43 •Z-13 -36Z-1 Address: ZI S NZ,-, Srt-�t.T y:. -CONTRACTOR Name ^_ -_` ,Ph.one x �..'.. 1. MY� 30 Address 041't3�-lS' �. Supervisor's.Construction'Lcense U S 3y�c\ °� Exp Date: S" Home Improvement License ` Exp Date �,AOL 6 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: $ so j -10 U FEE: $ 620 __ `•; Check No.: Receipt No.: l�F NO'T'E: Persons contracting ith unr eyed c ractors do not have access to the guaranty fund Signature of Agent/Owner iginature_of contractor Plans Submitted a ans Waived Certified Plot Plan ❑ Stamped PI •7 BUILDING PERMIT o*No oT b�ti TOWN OF NORTH ANDOVER 3� h�.' •6 vL APPLICATION FOR PLAN EXAMINATION 0z Permit No#: Date Received A 4 o0lK.l�KP. 7 R'TED rP"�y gSSACHUS Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION; Print -- PROPERTY OWNER'-. ---_-- _ Print ' l oo Year Structure yes no MAP ___PARCEL: __ ZONINGrDISTRICT:Historic District yes no Machine Shop Village 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 E Septic 0 Well ❑ Floodplain ❑Wetlands 0 Watershed.District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor{Narae: Phone: Address: Supervisor's Construction License _- ;Exp. Date: _ Homme Improvement License:---,- _- s Exp. Date: 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: $ FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signatureof contractor 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 PLANNING & DEVELOPMENT Reviewed On Signature_ j COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit r DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DE-P-A►RTME_NT Temp Dumpsterion site yes ,-- . = no .Located at 124 MainStreet Fire. Department signature/date COMMENTS - Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email 3 Date Time Contact Name Doc.Building Permit Revised 2014 4 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/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 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 ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Location No. � Date i e - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ X� 17%1) i. TOTAL $ Y"1 Checkft Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 50,700.00 m $ - $ 608.40 Plumbing Fee $ 76.05 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 76.05 Total fees collected $ 860.50 295 Main Street 399-15 on 10/28/2014 Two Bathroom Remodel MORTH Town of s : ndover 0 ver, Mass, .6 ,x zt. 2e.iq 0 Q coc.uc Ml WIC. 1•o ��. S V BOARD OF HEALTH j Food/Kitchen PERMI LD Septic System i THIS CERTIFIES THAT ....... , ,,, �,�,,,,,, BUILDING INSPECTOR ►.T....o►t�N.... ........ ............ . . .. .. ..... has permission to ere ...... buildin s on .. Foundation .. ... . .. ... . .... ... Rough tobe occupied as ................................!............. .........................0. .... . . ...... ....... .... Chimney provided that the person accepting this permit shall in every respect c form to t e terms of the application 1S Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR • UNLESS CONSTRUCTIOW4TALR Rough Service ......... ...................................... Final BUILDING INSPECTOR 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. t i 4 Massachusetts -Depart Tient of Public.Safety it V Board of Building Regulations and Standards Construction Supen'isor License: CS-053099 w KEVIN W 1V mift 98 FOREST ST 1 North Andover WA 0j14jPji( Expiration 541: 06129/2015 Commissioner r U/ Office of Consume i OME IMp Affairs&Busibes��cr�°a��ure . I egistratioROVEIIIIENrCONTRACr Regulation 101.874 s` -Viration:.-:::6129/20-1-6 TYpe: I KEVIN MURP8y Individual i Kevin Mur j Phy 98 FOREST ST. N.ANDOVER, MA 01845 Undersecretary i r� 91 98 Forest Street Kevin Murphy, • North Andover,MA 01845 • PH:978-688-5335 Building Contractor • FAX:978-688-7207 Proposal To: John&Karen Carroll 295 Main Street All Home improvement Contractors and subcontractors engaged in home improvement contracting,unless North Andover, Ma. 01845 specifically exempt from registration by Provisions of Chapter 142A of the general laws,must be registered with the Commonwealth of Massachusetts.Inquiries about registration and Status should be made to the Director,Home Improvement Contract Registration,One Ashburton Place, From: Kevin Murphy Room 1301,Boston,MA 02108(617)-727 8598 CC: Date: 10/28/2014 Job: Baths/Windows Date of plans: 7/14 Architect Location: Same Section 1-Work Schedule Contractor will begin the work or order the materials before the third day following the signing of this agreement, unless specified here in writing contractor will begin work on or about 9/25/14. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 11/30/14.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 III—Scope of Work Page 1 of 4 l Kevin Murphy Page 2 of 4 Building Contractor 98 Forest street North Andover,MA 01845 PH:97BZ88-5335 FAX 978-688-7207 General Proposal is to renovate existing full bath, add master bath, and replace existing windows. Plans to be provided by owner. Permits will be provided by contractor. Demolition Existing full bath will be completely gutted. Building All framing materials required to relocate existing bathroom petitions will be provided. All framing / siding materials required to replace / install windows will be provided. Fourteen Harvey double hung, all vinyl replacement windows will be supplied and installed in existing openings. An allowance of $5000 has been included to supply awning windows in master bath, and casement / awning windows in front of house ( to replace big bow window) . Awning windows in master bath will be built out, as shown on plans. One Velux sun tunnel will be supplied and installed. Plumbing Plumbing required to renovate main bath, and create new master bath as shown on plans, will be provided to meet code. Plumbing fixtures to be provided by owner. Electrical Electrical work required to wire bathrooms to code will be provided. Two Panasonic bath fan/lights will be supplied and installed. Surface mounted fixtures ( vanity lights ) to be supplied by owner / installed by contractor. Heating/Air Conditioning Forced hot water heating will be relocated /added as required to properly heat both bathrooms. No allowance has been made for any air conditioning or radiant heat. Insulation Renovated areas will have fiberglass insulation installed to code. Plaster Renovated areas will be blueboarded and skimcoat plastered.Walls and ceiling will be smooth. Interior to or TrimlDoors Pre-primed interior trim and doors will be supplied and installed to match existing. Bath vanities to be supplied b owner, installed b contractor. Y Y Painting No allowance has been made for any painting. Flooring 1 Kevin Murphy Building Contractor Page 3 of 4 98 Forest Street North Andover,MA 01845 PH:978688-5335 FAX 97868&7207 Tile floors will be provided in bath bathrooms. Main bath will have tub walls tiled. Masterbath will have tile shower.An allowance of$7 per square foot has been included for tile materials. Waste Removal All demolition/construction debris will be disposed of by contractor. Items Not Included No allowance has been made for any masonry work,or replacement of any exterior doors. I i Kevin Murphy Building Contractor Page 4 of 4 98 Forest Street North Andover,MA 01845 PH:978688-5335 FAX:97868&7207 Section IV-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ... ... ... ... ... ....... ... ... ....$ 501700 Payment to be made as follows: Percentage/Item Description Amount 1 Permit obtained $2700 2 Demolition complete $5000 3 Rough plumbing / electric complete $15,000 4 Windows installed $12,000 5 Plastering complete $5,000 6 Tile complete $6000 7 Job 100% complete $5000 Total 7 $50,700.00 "Notice:No agreement for Home improvement contracting work shall require a down payment(advance deposit)of more that one third of the total contract price of the total amount of all deposits or payments which the contractor must make,in advance,to order arKYor otherwise obtain delivery of special order materials and equipment,whichever is greater Contractor: Kevin Murphy 98 Forest Street No.Andover, MA 01845 Registration No: 101874 Section V-Acceptance Acceptance of Proposal—I have read this document and accept the prices, specifications,and conditions stated. I understand that upon signing,this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. You the buyer may cancel this transaction at any time prior to midnight on the third business da after the 9 y date of this transaction cancellation must be done in writing DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date Z Signature Date The Commonwealth of Massachusetts Department of Industrial Accidents Office of Invesfigations IN 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name(Business/Organization/Individual): Address: `�$ 1� � S�„� City/State/Zip:_ tyv t^,_ o k t t T-Phone#: Are you an employer?Check the appropriate box: Type of project(required): 4 1. I am a employer with . ❑ d I I am a general contractor an ` i � —�-- 6. ❑New construction employees(full and/or part-time)." have hired the sub-contractors 2.F1 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 me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its re 10.❑Electrical repairs or additions required.] officers have exercised their q ] o 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 [No workers.ees t employees.insurance required.] p y .insurance required.] 13.[i Other comp. q ] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:. t-,00 V o�,_ ..Lb..f wti.--y- C Policy#or Self-ins.Lic.#: �( U-C. S1-71 ee q1-k Expiration Date: Job Site Address: ZR S- N\4 77_ ` Sr^1`'�'fi City/State/Zip: Nv 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 of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Sienature: Date: tj Phone#: 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.EIectrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: DATE ACCM� CERTIFICATE OF LIABILITY INSURANCE 6/25/2014 Y 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 NOMHACT Sandi Munroe M P ROBERTS INS AGCY INC PHONEg']j; 683-8073 FA'(AIs N :(978) 683-3147 1060 Osgood Street ppR�:san i mpro ertsinsurance.com North Andover, MA 01845 INSURERS AFFORDING COVERAGE NAIC# INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURERB: GUARD INSURANCE 169 BOXFORD STREET INSURER C: NORTH ANDOVER, MA 01845 INSURER D: INSURER IN RERF: 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 TIE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSUL bUOK LTR TYPE OF INSURANCE INSDPOLICYNUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR PREMISES E urre $ 500,000 BOPI068945 11/22/13 1/22/14 MEDS one person) $ 15,000 A PERSONAL&ADV INJURY $ INCLUDED GEN'LAGGREGATE LIMIT APPLIESPER GENERAL AGGREGATE $ 2,000,000 POLICY PRO- ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT J Ea ant $ r r ANYAUTO BODILY INJURY(Per person) $ A ALTOSWNED N SCHEDULED MCA7013608 01/23/14 1/23/15BODILY INJURY(P�accdent) $ HIREDAUTOSNON-OWNED PROPERTY DAMAGE AUTOS t $ UMBRELLA UAB OCCUR EACH OCCURRENCE $—17,000,o0o0 ,000,000 A EXCESS UAB CLAIMS-MADE CUP9145304 11/22/1311/22/14 AGGREGATE $ r=r DED RETENTION WORKERS COMPENSATION X I PER OTH- AND EMPLOYERS'LIABILITY T T TEER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFlCER/MEMBER EXCLUDED? N/A (Mandatory in NH) KEWC527844 07/01/14 7/01/15 E.L.DISEASE-EA EMPLOYEE $ 500,000 crbendr DES FIs ONuFaOPERATIONS I00 000 E.L.LDISEASE-POLICY UMI r DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Addibonal Remarks Schedule,maybe attached ifmorespace isrequired) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 OSGOOD STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE M N I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD