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Building Permit #821-15 - 37 COURT STREET 4/21/2015
�1�4�ml�da�c Permit No#: ?a /,:�, Date Issued: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received •64 C 02 PROPOSED USE T Z H IMPORTANT: Applicant must complete all items on this page —� LOCATION S_sr to _ Print PROPERTY OWN Print 100 Year Structure MAP V PARCEL -M3 ZONING DISTRICT: Historic District Machine Shop Vill yes yes e yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building tOne family ❑ Addition ❑ Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain 0 Wetlands. ❑ Watershed District ,Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identificatin - Please Type or Print Clearly OWNER: Name: IZP Cep' Phone: R1 a� j • �iT3 Address: Contractor NameA& ,,'. h a,,,t„ Phone: Address: i ✓ r 'i" S's ��.�..T �+ :.dl�,u:... M�•�... Supervisor's Construction License: fig 3 0 Exp. Date: ► Zr. 1 ! f Home Improvement License: Date: ARCH ITECT/ENGINEER vy. Phone: ;F 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: $ `$3 FEE: $ 'L2,2— Check No.: /,/� 7el-.!�— Receipt No.: 2-WJ NOTE: Persons contracting with un re istered contractors do not have acces to the guaranty fund Signature vnei Signature of contracto / f Location - No.� /( Date Check # TOWN OF NORTH ANDOVER Certificate of Occupancy $ z Building/Frame Permit Fee $ ' Foundation Permit Fee $ x Other Permit Fee $' ` TOTAL $ Au/uiilding Inspector Inspector •` t Plans Submitted ❑ Plans Waive 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_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes hA �i .,Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: FIRE DEPARTMENT - Temp'Dumpster on site yes Located at 124 Main Street Fire Department signature/date COMMENTS Located 384 no 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 Ema Date Time Contact Name Doc.Building Pennit 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 ❑ 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 o 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) ❑ 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 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost 8,500.00 m $ - $ 222.00 Plumbing Fee $ 27.75 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 27.75 Total fees collected $ 377.50 37 Court Street 821-15 on 4/21/15 Bathroom Remodel j Q W LL m \moi Y T N U O. G1 N p WW Z Z O J m C O m 3 O LL L tw 3 O d' O C LL pz W Z Z CmC C 3 d L bo 3 ,/ O� LL. N C LL Z U G W L TC: O w U N N 'OeE77* W N " j Q W LL m cu L \ O O LL Y T N U O. G1 N p WW Z Z O J m C O m 3 O LL L tw 3 O d' cu T C E L U C LL pz W Z Z CmC C 3 d L bo 3 ,/ O� LL. N C LL Z U G W L TC: O w U N N m C LL W N " L 3 O cr _ C LL oC W ° LLI � U- N 3 m O Z N - N r v Y O E N O J H Z m cc Z W w X LUH G W 0- O W Z Z O Ca a O� V Z 0 C/) LU J �v w It CD E d O w 0 O O Z Otm = O — N0 � .E m m 0 � o � � Q O= _ v_ J 0-0 ,d; = Z O V N O a M CL CA B 0 0 � R C. d G> Q O E a � ) t r-. 0 cc 3 4) E in Lm a t� > Z y A 41 �. N � 0-0 0 Q C 0 o . o N C � i L c 21 �a S N o ti o c c Q o O rn Q"0pip 0 W = 0 -a O O LL 2 N C 0 H w w 0 E a Z O LU W i v 0 .o. Q. o 0 > Z m cc Z W w X LUH G W 0- O W Z Z O Ca a O� V Z 0 C/) LU J �v w It CD E d O w 0 O O Z Otm = O — N0 � .E m m 0 � o � � Q O= _ v_ J 0-0 ,d; = Z O V N O a M CL CA B Kevn.Murphy Building Contractor4 i Proposal To: John & Regina Jesser 37 Court Street North Andover, Ma. 01845 From: Kevin Murphy CQ Date: 4/20/2015 Job: Bath Renovation Date of plans: None Architect None Location: Same Section 1- Work Schedule • 98 Forest Street • North Andover, MA 01845 • PH: 978-688-5335 • FAX: 978-688-7207 All Home improvement Contractors and Subcontractors engaged in home improvement contracting, unless 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, Room 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 specified here in writing contractor will begin work on or about 4/13/15. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 5/30/15. 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 11- Warranty The Contractor warrants that the work furnished 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 Kevin Murphy Btulding Contractor 98 Forest Street North Andover, MA 01845 PH:97BZ885335 FAX 97868B-7207 General Proposal is to renovate existing main bathroom. Permits will be obtained by contractor. Demolition Existing bathroom will be completely gutted. Building Page 2 of 4 All frame and siding materials will be supplied by contractor. Existing window will be removed. New Harvey all vinyl awning window will be supplied and installed. Siding / exterior trim to match existing. Plumbing Plumbing required to renovate bath will be provided. Bathroom layout to remain the same. Fixtures to be supplied by owner, installed by contractor. Electrical Electrical work required to wire bathroom to code will be provided. New Panasonic bath fan/ light will be supplied and installed. Surface mounted fixtures to be supplied by owner, installed by contractor. General layout to be approved by owner prior to rough. Heating/Air Conditioning Existing heating unit will be replaced with new baseboard. Insulation Fiberglass insulation will be supplied and installed. Plaster Bathroom will be blueboarded and skimcoat plastered. Walls and ceilings will be smooth. Interior Trim/Doors Pre -primed interior trim will be supplied and installed to match existing. Interior doors to remain. Bath vanity / counter to be supplied by owner, installed by contractor. 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 Tile floor will be supplied and installed. Walls around new tub, will also be tiled. An allowance of $7 per square foot has been included for the material. Kevin Murphy Building Contractor 98 Forest Street North Andover, MA 01845 PH: 9784688-5335 FAX 978688-7207 Waste Removal All demolition / construction debris will be disposed of by contractor. Items Not Included No allowance has been made for a closet organizer. Page 3 of 4 Kevin Murphy Building Contractor 98 Forest Street North Andover, MA 01845 PH: 978488-5335 FAX 978-688-7207 Section IV — Price Schedule Total Page 4 of 4 We hereby propose to furnish material and labor — complete in Accordance with above specifications for the sum of .....................................$ 18,500 Payment to be made as follows: Percentage/Item Description Amount 1 Deposit / permit obtained .$2500 2 New window installed $9000 3 Trim / the complete $4000 4 Job 100% complete $3000 4 1 $18,500.00 "Notice: No agreement for Home improvement oD,.b ing 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 and/or 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 day after the date of this transaction cancellation must be done in writing DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signature Date KIull-r Signature Date The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers. TO BE FILED WITH THE PERvIITTING AUTHORITY. Annlicant Information Please Print Legibly Name (Business/Organization/Individual): Address: T 16 Gr es T_ City/State/Zip: t4- (^„, 0%V,4 -T- Phone #: _ ei`I T )p IM •'5-33 T' Are you an employer? Check the appropriate box: 1. I am a employer with employees (full and/or part-time).* 2. I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t 4.❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5.❑ I 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. insurance.t 6.❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 7. ❑ New construction 8. { Remodeling 9. u�j Demolition 10 ❑ Building addition ll.❑ Electrical repairs or additions 12. ❑ Plumbing repairs or additions 13. ❑ Roof repairs 14.❑ Other ;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. #Contractors that check this box must attached an additional sheet 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 polley and job site information. {{ (� Insurance Company Name: 6✓r�f �- 'i.-SCJ Policy # or Self -ins. Lic. #: S-70 fi tl. A Expiration Date: Job Site Address: 3 Ga— City/State/Zip: �-►i 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 herby certify under the pains and penalties of perjury that the information provided above is true and correct 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 Cleric 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #• A �>� CERTIFICATE OF LIABILITY INSURANCE 6/25/2o4p""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(es) 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 endorsements . PRODUCER M P ROBERTS INS AGCY INC 1060 Osgood Street North Andover, MA 01845 Sandi Munroe (978) 683-8073 ac No (978) 683-3147 FE-NAIL:san 1 mpro ertslnsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING 169 BOXFORD STREET NORTH ANDOVER, MA 01845 INSURERB: GUARD INSURANCE INSURER INSURER D: INSURER E INSURER F: COVFRAGFS CERTIFICATE NIIMRFR• P1=VI.CICTN NIIMRFR- 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 MAYHAVE BEEN REDUCED BYPAID CLAIMS. LTR TYPE OF INSURANCE NSD D POLI YN MBER PO/IDCY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 CLAIMS -MADE ®OCCUR SES Ea occurrence $ 500,000 MED EXP one assn $ 15 000 BOPI068945 11/22/13 1/22/14 PERSONAL&ADV INJURY $ INCLUDED A GEN'LAGGREGATEUMITAPPLIESPER GENERAL AGGREGATE $ 2,000,000 ❑ jECT- ❑ PRODUCTS - COMP/OP AGG $ 2f000'000. POLICY LOC AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ 1,000,00 (Ea accident) BODILY INJURY (Papersm) $ ANYAUTO MCA7013608 01/23/14 1/23/15 A]AUTOS ALLOWNED X SCHEDULED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ NON -OWNED HIRED AUTOS AUTO Pa t UABOCCUR EACH OCCURRENCE $ 1,00 '0 AHUMBRELLA EXCESS UAB HCLAIMS-MADE CUP9145304 11/22/13 1/22/14 AGGREGATE $ , 00,0 DED RETENTION WORKERS COMPENSATION X sTn UTE OEJZH AND EMPLOYERS' UABILIY 500,000 B ANY PROPRIEFORIPARTNERIEX13CUTNE OFRCERIMEMBER NIA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE 1 $ EXCLUDED? (Mandatory in NH) KEWC527844 0-7/01/14[17/01/15 5OO OOO If es, deserbe under O O OPERATIONSE. I r DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Addificnal Remarks Schedtft may be attached if mare space's required) CFRTIPICATF POI IIFR rANr`FI I ATIr)M TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 OSGOOD STREET NORTH ANDOVER MA 01845 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATNE ©1988-2014 ACORD CORPORATION. Al rights reserved. ACORD 25 (2014!01) The ACORD name and logo are registered marks of ACORD 9 Go > 2� 0 �\2 �f 0 \5% 77�°a 0 of \ /�0 (D7 Q / \ \ 2 a ' fk�■t \kk »f`y�{2. / / , .a© T. :& D= 2 �\ $ & } � � q§6 I ƒ 7f�, & % eo \\ & \( \/ \// � ch; � 2� �\2 �f / $ 0 § /�0 (D7 Q / \ \ 2 \ \ »f`y�{2. / / , .a© T. :& D= $ & § / & % \\ \// ch;