HomeMy WebLinkAboutBuilding Permit #45-11 - 316 RALEIGH TAVERN LANE 7/19/2011 < f NORTFf q
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BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION "
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Permit N0: �/ Date Received
�9SSACHUS��,(
Date Issued: rl -
IMPORTANT:Applicant must complete all items on this page
LOCATION P_
Print
PROPERTY OWNER
Print
MAP NO:10 PARCELQJ�ZONING DISTRICT: 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
Re air, replacement ❑Assesso Bldg ❑ Others:
p p ry 9
Demolition 0 Other
❑ Septic ❑Well ❑ Floodplain ❑ Wetlands ❑ Watershed District
❑ Water/Sewer
DESCRIPTION OF WORK TO BE PREFORMED:
P�.,,,�o:l 4,�,s- C?�..e�ye. o ''�j�ace-c�j \oc�r:e�c► _ .,ems b �1-oti.+es',
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I�P��t��5rib-� �lcrr T n �1as cs tJc it orr+
Identification Please Type or Print Clearly)
OWNER: Name: Phone: 919 <LgL. t- 5:;L
Address: Silo NA over.
CONTRACTOR Name�2k,6c) Phone: '9')Z -kkjl •L4t-4-1
Address: �3 Zw:l;�c4,l� �c_ 1�3c3sr,,, NN nSO6Q.
Supervisor's Construction License:-GS 103o90 Exp. Date: it /Z(. k
Home Improvement License: lk,,>1J',03 Exp. Date: toll
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: $ _ y 3�'-� l , oo FEE: $ 51'9, 9f)
Check No.: 440cl / 2 e2 Receipt No.:
NOTE: Persons conffa&hng with unregistered contractors do not have acces to guaranty fund
Signature of Agent/Owner Signature of 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
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 Driveway Permit
Located at 384 Osgood Street
FIRE DEPARTMENT -Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMMENTS
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" Dimension
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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
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❑ Notified for pickup - Date
__.--------_---..___._----_.____.__.......___......---_..____.__..___......._.____---.
Doc.Building Permit Revised 2007
The Commonwealth of Massachusetts
Department of Industrial Accidents
M.,l Office of Investigations
' 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);a�a..',A s T�V�� � 6U;Uere
Address: 17 -',.,,1'►" �c
City/State/Zip: Nay�.,,�,,,c�, t.>" oso bgp- Phone#: '9116 • �-1�1 • -1b,-1'1
Are you an employer?Check the appropriate box: Type of project(required):
t.❑ t am a employer with_ 4. ❑ 1 am a general contractor and I 6. ❑New construction
eloyees(full and/or part-time).* have hired the sub-contractors
Kla'mv a sole proprietor or partner- listed on the attached sheet.i ❑ Remodeling
ip and.have no employees These sub-contractors have 8. ❑Demolition
workingfor me in an capacity. workers' comp. insurance.
Y9. F-1 Building addition
[No workers'comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.F-1 Electrical repairs or additions
3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.[] Plumbing repairs or additions
myself, [No workers'comp. c. 152, §t(4),and we have no 12.❑ Roof repairs
insurance required.]t .employees. [No workers' 13.❑Other
comp. insurance required.]
"Any applicant that checks boz#l 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.
$Contractors 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:
Policy#or Self-ins. Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under 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 DCA for insurance coverage verification.
I do hereby certify under the pains andpenalties of perjury that the information provided/above is true and correct.
Signature: Date: l i t
Phone#: 1�• �-#b� • `'{�,�"l
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 S. Plumbing Inspector
6.Other
Contact Person: Phone#:
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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 of hire,
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 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 cavy workers'compensation insurance. if 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 confnnation 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 permit/license 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 pen-nit 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 Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street.
Boston, MA 02111
Tel. #617-727-4900 ext 406 or 1-8.77-MASSAFE
Revised 5-26-05 Fax#617-727-7749
VAM.Mass.gov/dia
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Aco�� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
6/22/2011
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 CONTACT
-NAME: ..
Infantine Insurance, Inc. MaHoNri,Extl, 603.669.0704 X10 FAX. 603.669.6831
P.O. BOX 5125 E-MA_A DRIESS: ... ....... -
Manchester NH 03108 PRODUCER
Manchester, CUSTOMESJD#,....
Sylvia Allard INSURER(S)AFFORDING COVERAGE NAIC#.
INSURED ..INSURER A.-Merchants Preferred Insurance
INSURER 8:
Northeast Bath Builders, LLC INSURER C:
496 Groton Road -INSURER D:
MUBERE. __---_--- .
Westford MA 01886 INSURER F,
COVERAGES CERTIFICATE NUMBER:10-11 Master Rev 9/30/10 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR- POLICY EFF POLICY EXP OMITS
J-,T-6 TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDNY , (Q..,Y",
GENERAL LIABILITY BOP9097614 08/31/2010'08/31/2011 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY ,PREM MAGE SPS Ea occur ence $TO RENTED 500,000
A CLAIMS-MADE Fx-1 OCCUR MED EXP(Any one person) $ 15 F000
PERSONAL&ADV INJURY $ Included
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
POLICY PRQ^ _ LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
i
(Ea accident) $
ANY AUTO
BODILY INJURY(Per person) $
ALL OWNED AUTOS
BODILY INJURY(Per accident) $
SCHEDULED AUTOS
� PROPERTY DAMAGE $
HIRED AUTOS (Per accident)
NON-OWNED AUTOS $
$
UMBRELLA UAB OCCUR '
EACH OCCURRENCE $
EXCESS UAB CLAIMS-MADE ,AGGREGATE ,$
1
DEDUCTIBLE
,RETENTION-T$ � $
WORKERS COMPENSATION I WCSTATU- 0TH-
AND EMPLOYERS'LIABILITY YIN ! TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE i E.L.EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED? NIA
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
w
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required)
Various work throughout the policy term.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Kathryn COltin ACCORDANCE WITH THE POLICY PROVISIONS.
316 Raleigh Tavern Ln
N. Andover, MA 01845 AUTHORIZED REPRESENTATIVE
ACORD 25(2009/09) 0 1988-200A ACORD CORPORATION. All rights reserved.
INS025(20090'=1) The ACORD name and logo are registered marks of ACORD
((// Y �
r. usiness Regulation
office of Consumer Affairs grid
10 Park Plaza- Suite 5170
Boston, Massachusetts 02116
r Home Improvement Cori>r;actor Registration
P , ••„
Registration: 164403
Type: LLC Tr# 289462
Expiration; 101112011
` BUILDERS,
NORTHEAST BATH
DAVID HA
MBLETT
13 TWILIGHT DR,
s;
NASHUA, NH 03062
. Update Address and return card Mark reason for change.
Address [' RenewalEmployment (-� Lost Card
DPS-W 0 SOM•04/04-0101216
rY� 'a»r..�iranrrrerr / r��'✓1%�`r,��rxclr�aoCd License or registration valid for individul use only
r � office of Consumer Affairs& Business Regulation before.the expiration date. If found return to:
� `? b
�ti'.' x•t"� HOME IMPROVEMENT CONTRACTOR Office;of Consumer Affairs and Business Regulation
Registration:... .:•184403 lop Ark Plaza-Suite 5'170
269462 Explration I IN2011
TO 289462 MA 02116
TYpe.'
NORTHEAST BATH BUII:DERS;;.LLC.
DAVID HAMBLETT
13 TWILIGHT DO-:
ithout si._......_.____._..ure
NASHUA,NH 03061-': ` .. undersecretary Not valid wold
gnature
#,Ir•qlay�##1 ni' Puilii� �;1i'a�t�' ..
B111#oc1 I,t
103090
License: CS
a to:
JG
R.estricte ,
DAV 10
HAMgi-ETT
OTON:ROP•D N0 4 .
496 GR 01886
WESTFORD, MA
Ex.piritioll: 1112612012
103090
i
Northeast Bath Builders LLC (603) 791 -4163
13 Twilight Dr
Nashua NH, 03062 Home-Improvement Contract
This Sales Agreement is made between Northeast Bath Builders and Purchaser:
Name: Kathy Coltin
Mailing Address: 316 Raleigh Tavern Lane
City: N. Andover State: MA Zip:
Phones: 978-397-1962 Evening:
NEBB agrees to furnish the following material and services at the stated price and on the following terms:
Materials and Services: Price
To remodel the existing 4 bathrooms to include the following: (See attached $38741.00
documents)
To remodel the existing master bedroom closet to include the following: (see $4500.00
attached document)
Total contracted Price: $43241.00
Any alteration or deviation from the above specifications involving extra costs will be done only upon a written change
order. The costs will become an extra charge over and above the estimate. This will include,but is not limited to,
hidden damages that are uncovered during the course of the job and additional work required by local building
inspectors.
An interest charge of 1'/z% per month If payment of this order or any part thereof is referred
o r collection Purchaser agrees to pay
amount to an attorney#o 9
(18/o per year) Is added to any amou y
unpaid after 3 days from due date. all reasonable attorney fees and costs of collection.
All elements of this agreement are contingent upon strikes,accidents or delays beyond our control. The estimate does not
should unforeseen
problems arise
include material price increases,or additional labor and materials which may be required
after the work has started.
Purchaser's Signature: Date: .3 le o�Il
NorthEast Bath Builders Date of
Acceptance:
Product purchased privately by homeowner is not covered under NEBB warranty. Any delays caused by defects
or malfunctioning product is not the responsibility of NEBB and will be returned or replaced by homeowner.
i v
603.791.4163
BATH
info{a�NortheastBathBuilders.com BUILDERS
"C" ,F - •a�a::s a a_ s et ss o a .
To remodel the existing Master, Full and two Half Baths to include the following:
Master Bath:
• Remove and dispose of the existing shower, closet,vanity, toilet, walls, ceiling and flooring
• Repair and replace any rotted or damaged subflooring and framing
• Move water lines and drainage to accommodate new layout
• Electrical:
o Run new 20 amp circuit from electrical panel
o Install new GFI outlet by sink and one beside window
o Install new 110CFM Panasonic Whisperlite Fan/Light(FV-11VQL5)
o Install a new recessed light in shower area
o Install a new vanity light(installation only; fixture not included)
o Install sconce on its own switch to wall space between toilet and corner cabinet(installation only;
fixture not included)
o Install new baseboard heating unit on pocket door wall
• Frame in pocket door
• Install a %" plywood underlayment over existing 3/a" subfloor
• Install a 48x34 Onyx Shower Base
• Frame in a 12" bench seat at end of shower area
• Install a Kohler Memoirs Shower Valve with Shower Head and separate handheld in
Brushed Bronze (BV) finish (product purchased separately by homeowner)
• Install new insulation
• Install cement board backer on walls above shower base to ceiling with waterproofing
membrane
• Install blue board on walls and ceiling
• Plaster walls with a veneer finish and leave ready for paint
• Tile shower area tceiling with ceramic the provided by homeowner
• Apply cement board to floor and tile with ceramic tile provided by homeowner
• Grout all tile with mold and mildew preventative added to grout
• Install a new solid core door for pocket door
• Install new baseboard trim and casing
• Install a new Kohler Memoirs Pedestal Sink in biscuit„(K-2258-8-96) with a Kohler
Memoirs Wideset Faucet in BV (K-454-4V-BV)- (p -odhct purchased separately by
homeowner)
oder window per drawin sand design with marble
• Custom..Maple Cabinet u g g
Install a C �I p ,� P
console top (marble top provided by homeowner)
• Install a Custom Corner Cabinet per drawings and design ]
• Install a Toilet Topper in Biscuit over toilet
Northutss Iulfh F.'an�4i._c. g. 1.1. -13,Twi 3 ht�C}TC Nashim NH 1�062 Fax-. 6017791-00-15
i
603.791.4163
BATH
info(c�Northeast$athsu;tders.com BUILDERS
\'\� N(-vt11casrP)athPAIiI("I�.T>. c�I11
• Install a Robern PLVYM24BB Framed Wall Mirror-- B
eade
d in
Biscuit
(provided db
Y
homeowner)
• Install a Toto Eco Lloyd Toilet (provided by homeowner)
• Install a Basco 1713 Two-panel Shower Door with notched panel in Brushed Bronze with
Heirloom Glass
Total Estimated Cost: $19,620
Drop cloths are placed from point of entry to
work site daily
Job site is left clean and free of debris daily
Permit fees are set per town and are not included in this estimate
�rthcast Bath Builders,LLC:. 13 Twibizhr Drive \:;shwa,N. I (�.�O6' Fax:x: b03.791.00l
a BATH
603.791.4163
info(a?NortheastBathsuilders.com BUILDERS
1,WW North astB at hill Iii1cl cr;corn
_ t _ t - � a0 aaa •a s ara ea
This page is an amendment to the signed contract. It is a correction/clarification requested by
the homeowner and provided by NEBB on this, the 28t'' of March, 2011.
Full Bath:
• Remove and dispose of the existing tub, toilet,vanity and flooring
• Repair and replace any rotted or damaged subflooring or framing
• Install a new %" plywood underlayment over existing 3/a" subfloor
• Install a new Advanta by Maax New Town 6002 tub (Purchased separately by
homeowner)
• Install American Standard Portsmouth Collection Shower Head and Trim with
coordinating valve (Product provided by homeowner)
o T420.501.295 Portsmouth Trim Kit-Satin Nickel
o R125 Pressure Balance Rough-in Valve
• Install American Standard Portsmouth Collection Roman Tub Filler w/Handheld
(Product provided by homeowner)
o 7420.901.295 Portsmouth Tub Filler w/personal Shower
• Electrical:
o Install new 20 amp GFI outlet
o Install a Panasonic Whisperlite Fan/Light FV-11VQL5 vented to outside
o Install new vanity light(Installation only; Fixture not included)
o Install toe-kick heater to cabinet
• Install cement board backer above tub to ceiling with waterproofing membrane
• Patch remaining walls and ceiling where necessary with blue board
• Plaster patched areas and leave ready for paint
• Tile above tub to ceiling with Azuvi Carrera ceramic wall file
• Install a new solid maple Custom Vanity
• Install a granite vanity top with a Toto LT577-01 undercounter sink and a American
Standard Portsmouth Monoblock Faucet in Satin Nickel (7415.001.295)- (Faucet and sink
provided by homeowner)
• Install mirror (product provided by homeowner)
• Install cement board underlayment to floor and file with Azuvi Carrera Tile
• Grout all file with mold and mildew preventative added to grout
• Install new baseboard trim
• Install a Toto Soiree Toilet (Toilet provided by homeowner)
Total estimated cost: $13112
(A $500 allowance was included for the cost of tile)
Drop cloths are placed from point of entry to work site daily
Job site is left clean and free of debris daily
Permit fees are set per town and are not included in this estimate
Nortlicast Bath Pwiklers,LLC. 13 TvAligllt Dr ve Nashua,NTH OjO62 Em 603,791.0015
. 603.791.4163
BATH
inFo@NortheastBachBuilders.com BUILDERS
NNAV\-V.Northcastl'athBullcler4.Latn
" °"""'°""fit
{jy� v�.u7 tt
Great room bath:
• Remove the vanity and toilet and save for reinstallation
• Remove and dispose of the linoleum flooring and underlayment
• Reinstall the vanity with a new faucet provided by homeowner
• Install cement board underlayment to floor and file with Alcorense Mali Marfil
• Grout tile with mold and mildew preventative added to grout
• Install new baseboard trim
• Reinstall toilet with new polished brass trip lever (American Standard 738837-0090A)
Total estimated cost: $2643
(A $150 tile allowance was included in the cost)
Drop cloths are placed from point of entry to work site daily
Job site is left clean and free of debris daily
Permit fees are set per town and are not included in this estimate
Northcas[Bath T udicEers,LLC. B 1--,viliahr Drive Nashua.tiN i"s062)' Fax: 60 .79I.Oi?I5
• ' O . s
603.791.4163
BATH
info�a�Northeast$ath$uilders.com BUILDERS
-^ •$ .. ..• . v
1" Floor Hall Bath:
• Remove and dispose of the toilet, sink and flooring
• Repair and replace any rotted or damaged subflooring
• Tile floor with cement board underlayment (Tile provided by customer)
• Grout tile with mold and mildew preventative added to grout
• Install a Strasser Azzurra Eurolav cabinet and top (bisc)
o SSW63.900 Vanity
o SSW63.250 Top
• Install a Hansgrohe Tango C Widespread Faucet (Product provided by homeowner)
• Install toe-kick heater to vanity
• Install a Toto Promenade Round Front Toilet (Toilet provided by homeowner)
• Install new baseboard trim
Total estimated cost: $3366
Drop cloths are placed from point of entry to work site daily
Job site is left clean and free of debris daily
Permit fees are set per town and are not included in this estimate
Noor .t ist Bata Rujldcrs,LLC. I.,Pwfli ht.Drive \a hua,NH 0.3.0 2 Fax: ('03.791.0015
s` 603.791.4163 BATH
info@NortheastBathBuilders.com BUILDERS_
To install a new closet in the master bath to include the following
• Remove and dispose of the two existing closets and window between closets
• Window
o Frame in window with 2x4s
o Install plywood, waterproofing and shingles to exterior of house
o Prime and paint new shingles (home-owner to provide matching paint)
o Install insulation and blue-board on interior of window
• Frame out new closet wall approximately 11.5 feet long to accommodate 4 sliding doors
• Install new light between existing lights
• Install blue-board on both sides of new wall and patch ceiling from old walls
• Plaster new wall and window with veneer plaster
• Prime and paint new walls and ceiling
• Install new base board trim
• Install four 30" sliding doors with mirrors on bedroom side
Total estimated cost $ 41P500
This estimate does not include flooring
'N"n rheast.Bath R ildcrs,LLC.. 13 Twilight Drive Nashua,NT-10306-2 Nati. 603.79!.0015
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Massachusetts Home Improvement Contract
This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard
language to protect homeowners.Seek legal advice if necessary.Any person planning home improvements should first obtain a copy of"A
Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling
the Office of Consumer Affairs and Business Regulation's Consumer Hotline at 617-973-8787 or 1-888-283-3757 or on our website.
Homeowner Information Contractor Information
i A-
Name Company Name
Lane-
Street Address(do t use a Post Office Box address) Contractor/Salesperson/Owner Name
N A o a-i
City/Town State Zip Code Business Address(Inust include a street address)
N O
Daytime Phone Evening Phone City/Town State Zip Code
rb 06-19 t 41 to
Mailing Address(if different from above) Business Phone Federal Employer ID or S.S.Number
Law requires that most home HIC Registration Number EExp�iration Date
improvement contractors have
a valid registration number t
The Contractor agrees to do the following work for the Homeowner: 1`O
(Describe in detail the work to be completed,specifying the type,brand and grade of materials to be used.Use additional sheets if necessary.)
Required Permits-The following building permits are Proposed Start and Completion Schedule-The following schedule will be adhered to
required and will be secured by the contractor as the unless circumstances beyond the contractor's control arise
homeowner's agent:
(Owners who secure their own permits will be excluded 1 13 t 1 Date when contractor will begin contracted work
from the Guaranty Fund provisions of MGL chapter
142A) 13 Date when contracted work will be substantially completed
Total Contract Price and Payment Schedule
The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: oC (*)
Payments will be made according to the following schedule:
$q21;�1'�S upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater)
$ D.F►Lo by IS / i 1 or upon completion of -4ar4 cka4e
$ by or upon completion of
$ upon completion of the contract.(Law forbids demanding full payment until contract is completed to both party's satisfaction)
The following material/equipment must be special $ to be paid for
ordered before the contracted work begins in order to
meet the completion schedule.(**) $ to be paid for
Notes:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may
not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material
which must be special ordered in advance to meet the completion schedule.
Express Warranty-Is an express warranty being provided by the contractor? No_Yes(all terms of the warranty must be attached to the contract)
Subcontractors-The contractor agrees to be solely responsible for the completion of the work described regardless of the actions of any third
party/subcontractor utilized by the contractor.The contractor further agrees to be solely responsible for all payments to all subcontractors for
materials and labor under this contract.
Contract Acceptance-Upon signing,this document becomes a binding contract under law.Unless otherwise noted within this document,the
contract shall not imply that any lien or other security interest has been placed on the residence.Review the following precautions and notices
carefully before signing this contract.
• Don't be pressured into signing the contract.Take time to read and fully understand it.Ask questions if something is unclear.
• Make sure the contractor has a valid Home Improvement Contractor Registration.The law requires most home improvement
contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration.You may inquire
about a contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787
or 888-283-3757.
• Does the contractor have insurance?Ask the contractor for his insurance company information so that you can confirm coverage,or
ask to see a copy of a"proof of insurance"document.
• Know your rights and responsibilities.Read the Important Information on this form and get a copy of the Consumer Guide to the
Home Improvement Contractor Law.
You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the
contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of
the third business day following the signing of this agreement.See the attached notice of cancellation form for an explanation of this right.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES
Two identical copies of the contract must be completed and signed.One copy should go to the homeowner.
The other copy should be kept by the contractor.
Contractor's Signature/Date Homeowner's Signature/Date
, u
Contractor Arbitration
The Home Improvement Contractor Law provides homeowners with the right to initiate an arbitration action(as
an alternative to court)if they have a dispute with a contractor.The same right is not automatically afforded to a
contractor,however.The contractor would have to resolve any dispute he/she has with a homeowner in court
unless both parties agree to the optional clause provided below.This clause would give the contractor the same
right to arbitration as is afforded to the homeowner by the Home Improvement Contractor Law.
The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a
dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has
been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the
consumer shall be required to submit to such arbitration as provided in Massachusetts General Laws,chapter
142A.
X X
Contractor's Signature Homeowner's Signature
Notice:The signature of the parties above apply only to the agreement of the parties to alternative dispute
resolution initiated by the contractor.The homeowner may initiate alternative dispute resolution even where this
section is not separately signed by the parties.
Homeowner's Rights
A homeowner's rights under the Home Improvement Contractor Law(MGL chapter 142A)and other consumer
protection laws(i.e. MGL chapter 93A)may not be waived in any way,even by agreement. However, homeowners
may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law.
Homeowners who secure their own building permits are automatically excluded from all Guaranty Fund provisions
of the Home Improvement Contractor Law.The contractor is responsible for completing the work as described, in
a timely and workmanlike manner. Homeowners may be entitled to other specific legal rights if the contractor
guarantees or provides an express warranty for workmanship or materials. In addition to guarantees or warranties
provided by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and
fitness for a particular purpose.An enumeration of other matters on which the homeowner and contractor legally
agree may be added to the terms of the contract as long as they do not restrict a homeowner's basic consumer
rights. If you have questions about your consumer/homeowner rights,contact the Consumer Hotline(listed
below).
Execution of Contract
The Contract must be executed in duplicate and should not be signed until a copy of all exhibits and referenced
documents have been attached. Parties are also advised not to sign the document until all blank sections have
been filled in or marked as void,deleted or not applicable.One original signed copy of the contract with
attachments is to be given to the homeowner and the other kept by the contractor.Any modification to the
original contract must be in writing and agreed to by both parties.Contracted work may not begin until both
parties have received a fully executed copy of the contract,and the three day recission period has expired.
•� a
Accelerated Payments A contractor may not demand payments in advance of the dates specified on the payment
schedule in cases where the homeowner deems himself/herself to be financially insecure. However,in cases
where the contractor deems him/herself to be financially insecure,the contractor may require that the balance of
funds not yet due be placed in a joint escrow account as a prerequisite to continuing the contracted work.
Withdrawal of funds from said account would require the signature of both parties.
Additional Information If you have general questions or need additional information about the Home
Improvement Contractor Law or other consumer rights,or if you wish to obtain a free copy of"Massachusetts
Consumer Guide to Home Improvement"contact:
Consumer Information Hotline
Office of Consumer Affairs and Business Regulation
10 Park Plaza, Room 5170, Boston, MA 02116
617-973-8787,888-283-3757 or visit the OCABR website at http://www.mass.gov/ocabr/
If you want to verify the registration of a contractor or if you have questions or need additional information
specifically about the contractor registration component of the Home Improvement Law,contact:
Director of the Home Improvement Contractor Registration
Office of the Consumer Affairs and Business Regulations
10 Park Plaza, Room 5170, Boston, MA 02116
617-973-8787,888-283-3757 or visit the OCABR website at http://www.mass.gov/ocabr/
Go online to view the status of a Home Improvement Contractor's Registration:
http://db.state.ma.us/homeimprovement/Iicenseelist.asp
For assistance with informal mediation of disputes or to register formal complaints against a business,call:
Consumer Complaint Section
Office of the Attorney General
617-727-8400
AND/OR
Better Business Bureau
508-652-4800,508-755-2548,413-734-3114
BATH
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To remodel the existing Master, FuII and two Half Baths to include the following:
Master Bath:
• Remove and dispose of the existing shower, closet,vanity, toilet,walls, ceiling and flooring
• Repair and replace any rotted or damaged subflooring and framing
• Move water lines and drainage to accommodate new layout
• Electrical:
o Run new 20 amp circuit from electrical panel
o Install new GFI outlet by sink and one beside window
o Install new 110CFM Panasonic Whisperlite Fan/Light(FV-11VQL5)
o Install a new recessed light in shower area
o Install a new vanity light(installation only; fixture not included)
o Install sconce on its own switch to wall space between toilet and corner cabinet(installation only;
fixture not included)
o Install new baseboard heating unit on pocket door wall
• Frame in pocket door
• Install a %" plywood underlayment over existing 3/4" subfloor
• Install a 48x34 Onyx Shower Base
• Frame in a 12" bench seat at end of shower area
• Install a Kohler Memoirs Shower Valve with Shower Head and separate handheld in
Brushed Bronze (BV) finish (product purchased separately by homeowner)
• Install new insulation
• Install cement board backer on walls above shower base to ceiling with waterproofing
membrane
• Install blue board on walls and ceiling
paint
• Plaster walls with a veneer finish and leave ready for p i
• Tile shower area to ceiling with ceramic tile provided by homeowner
• Apply cement board to floor and tile with ceramic tile provided by homeowner
• Grout all file with hold and mildew preventative added to grout
g
• Install a new solid core door for pocket door
• Install new baseboard trim and casing
• Install a new Kohler Memoirs Pedestal Sink in biscuit(K2258-8-96)with a Kohler
Memoirs Wideset Faucet in BV (K-454-4V-BV)- (p uct purchased separately by
homeowner)
• Install a Custom Maple Cabinet under window per drawings and design with marble
console top (marble top provided by homeowner)
• Install a Custom Corner Cabinet per drawings and design
• Install a Toilet Topper in Biscuit over toilet
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• Install a Robern PL�'VM24BByFramed Wall Mirror-Beaded in Biscuit tprovided by
homeowner)
• Install a Toto Eco Lloyd Toilet (provided by homeowner)
• Install a Basco 1713 Two-panel Shower Door with notched panel in Brushed Bronze with
Heirloom Glass
Total Estimated Cost: $19,620
Drop cloths are placed from point of entry to work site daily
Job site is left clean and free of debris daily
Permit fees are set per town and are not included in this estimate
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This page is an amendment to the signed contract. It is�a correction/elarification requested by
the homeowner and provided by NEBB on this,the 28 of March,2011.
Full Bath:
• Remove and dispose of the existing tub,toilet,vanity and flooring
• Repair and replace any rotted or damaged subflooring or framing
• Install a new Yi" plywood underlayment over existing 3/4" subfloor
• Install a new Advanta by Maax New Town 60x32 tub (Purchased separately by
homeowner)
• Install American Standard Portsmouth Collection Shower Head and Trim with
coordinating valve (Product provided by homeowner)
o T420.501.295 Portsmouth Trim Kit-Satin Nickel
o R125 Pressure Balance Rough-in Valve
• Install American Standard Portsmouth Collection Roman Tub Filler w/Handheld
(Product provided by homeowner)
o 7420.901.295 Portsmouth Tub Filler w/personal Shower
• Electrical:
o Install new 20 amp GFI outlet
o Install a Panasonic Whisperlite Fan/Light FV-11VQL5 vented to outside
o Install new vanity light(installation only;Fixture not included)
o Install toe-kick heater to cabinet
• Install cement board backer above tub to ceiling with waterproofing membrane
• Patch remaining walls and ceiling where necessary with blue board
• Plaster patched areas and leave ready for paint
• Tile above tub to ceiling with Azuvi Carrera ceramic wall tile
• Install a new solid maple Custom Vanity
r sink and a American
• Install a granite vanity to with a Toto LT577 Ol undercounte .
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Standard Portsmouth Monobloek Faucet in Satin Nickel (7415.001.295)- (Faucet and sink
provided by homeowner)
• Install mirror (product provided by homeowner)
• Install cement board underlayment to floor and file with Azuvi Carrera Tile
• Grout all tile with mold and mildew preventative added to grout
• Install new baseboard trim
• Install a Toto Soiree Toilet (Toilet provided by homeowner)
Total estimated cost: $13112
(A$500 allowance was included for the cost of tile)
Drop cloths are placed from point of entry to work site daily
Job site is left clean and free of debris daily
Permit fees are set per town and are not included in this estimate
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Great room bath:
• Remove the vanity and toilet and save for reinstallation
• Remove and dispose of the linoleum flooring and underlayment
• Reinstall the vanity with a new faucet provided by homeowner
• install cement board underlayment to floor and file with Alcorense Mali Marfil
• Grout tile with mold and mildew preventative added to grout
• Install new baseboard trim -
• Reinstall toilet with new polished brass trip lever (American Standard 738837-0090A)
Total estimated cost: $2643
(A $150 tile allowance was included in the cost)
Drop cloths are placed from point of entry to work site daily
Job site is left clean and free of debris daily
Permit fees are set per town and are not included in this estimate
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1" Floor Hall Bath:
• Remove and dispose of the toilet,sink and flooring
• Repair and replace any rotted or damaged subflooring
• Tile floor with cement board underlayment(Tile provided by customer)
• Grout tile with mold and mildew preventative added to grout
• Install a Strasser Azzurra Eurolav cabinet and top (bisc)
o SSW63.900 Vanity
o SSW63.250 Top
e Install a Hansgrohe Tango C Widespread Faucet (Product provided by homeowner)
• Install toe-kick heater to vanity
• Install a Toto Promenade Round Front Toilet(Toilet provided by homeowner)
• Install new baseboard trim
Total estimated cost: $3366
Drop cloths are placed from point of entry to work site daily
Job site is left clean and free of debris daily
Permit fees are set per town and are not included in this estimate
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To install a new closet in the master bath to include the following
• Remove and dispose of the two existing closets and window between closets
• Window
o Frame in window with 2x4s
o Install plywood, waterproofing and shingles to exterior of house
o Prime and paint new shingles (home-owner to provide matching paint)
o Install insulation and blue-board on interior of window
• Frame out new closet wall approximately 11.5 feet long to accommodate 4 sliding doors
• Install new light between existing lights
• Install blue-board on both sides of new wall and patch ceiling from old walls
• Plaster new wall and window with veneer plaster
• Prime and paint new walls and ceiling
• Install new base board trim
• Install four 30" sliding doors with mirrors on bedroom side
Total estimated cost $ 4,500
This estimate does not include flooring
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Town
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No.
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4
IHE
COC MICCHE WICK �
ADRATED
S BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT......... ................... ...........
... ................ Foundation
has permission to erect.. buildings on .4314........ ... `.............. . Rough
to be occupied as.. .... !' ....... ....... .� h! ..........�i'�/�9kI.. ............ .........................
Chimney
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provided that the p on ac ting 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, 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
Sig$ PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRU N ARTS Rough
Service
..... ...........................................
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE,DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner,
Street No.
SEE REVERSE SIPE smoke Det.
Location
No. - a"' Date
"ORT" TOWN OF NORTH ANDOVER
Oit�•n •,h0
0 -
^, Certificate of Occupancy $
CHUS Building/Frame Permit Fee
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # 13d
24662
Building Inspector