HomeMy WebLinkAboutBuilding Permit #636-15 - 41 VILLAGE GREEN DRIVE 2/4/2015Permit No#:
Date Issuee-.,4- - `f
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
I IMPORTANT: Applicant must complete all items on this page
LOCATION L/ 'r A ece/Y
Print
NORTh\
�Orr----'N
eo
� Y
PROPERTY OWNER Rag /Ic C11V N15
Print 100 Year Structure yes
MAP PARCE?4" ZONING DI TR1CT: Historic District yes n
L Machine Shop Village I yes no
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ One family
❑ Addition
❑ Two or more family
❑ Industrial
0 Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
C�emolition 1,V7d,(1vA
❑ Other
❑ Septic 0 Well
❑ Floodplain 0 Wetlands
❑ Watershed District
❑ Water/Sewer
DESCRIPTION OF WORK TO BE PERFORMED:
B/LO%dn+ PbAd- Wd7cr4,04-11-44J4J- SdAillGd. /2ornod�4 Glics*T
-QA V w,4 a- Yd CM Ae T G A- " 4A w-",0 L A(_6 aT41arw* �
Identification - Please Type or Print Clearly
OWNER: Name: kLo�� (/,y�/l� Phone: 2 78 3 —,f
Address:
h
Contractor Name: M9-4&-ttiw, Phone: 7&� —1?2—7Yd0
Address: 3 Iti/aR71l �,r�A S'?- wa&l", zn 4 algal
Supervisor's Construction License: c S -o A !7 9 9 Exp. Date:
Home Improvement License:
ARCHITECT/ENGINEER
. Dater /6/ z S//b
Phone:
Address: Reg. N
FEE SCHEDULE: BULDING PERMIT. • $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ L12 9 y, �O FEE: $ 2 401,
Check No.: Cq'3L373: e Receipt No.: �,1� ��d-e-'—
NOTE: Persons contracting with unregistered contractors do not have access to the guar my fun
Signature of Agent/Owner ��� Signature of contractor.
Plans Submitted ❑
Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
SEWERAGE DISPOSAL
7-TypF'OF
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
COMMENTS
CONSERVATION
COMMENTS
HEALTH
COMMENTS
i
Signature
Reviewed on Signature
Reviewed on Signature
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision:
Conservation Decision:
Comments
Water & Sewer Connection/Signature & Date Driveway Permit
DPW Town Engineer: Signature:
FIRE DEPARTMENT - Temp Dumpster on site yes
Located at 124 Main Street
Fire Department signature/date
COMMENTS
Locatea Jd4 Usgooa Street
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 Email
Date Time Contact Name
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
❑ 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)
❑ 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 �4 w1w,"'o-
No. Date
A(Ar
Check #
4. L; L)
.1
TOWN OF NORTH ANDOVER
Certificate of Occupancy
$
Building/Frame Permit Fee
s7W
Foundation Permit Fee
$19r
Other Permit Fee
$
TOTAL
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Pro -Care, Inc
Client: Rob McGinnis
Property: 44 Village Green Drive
North Andover, MA 01845
Operator: DAVID
Estimator:
David Andrs
Position:
Emergency Manager
Company:
Pro -Care, Inc
Business:
3 North Maple Street
Woburn, MA 01801
Type of Estimate: Water Damage
Date Entered: 7/23/2014
Price List: MABO8X_JULI4
Labor Efficiency: Restoration/Service/Remodel
Estimate: W14 -024109W
Date Assigned: 7/21/2014
Home: (978) 239-8486
Business: (781) 933-7400
E-mail: david@pro-careinc.com /
PRO -CARE TO PERFORM THE FOLLOWING SERVICES. INVOICE TO FOLLOW BASED ON THESE FIGURES.
Pro -Care, Inc
W14 -024109W
Main Level
bedrooml
DESCRIPTION
Height: 8'
QTY UNIT PRICE TOTAL
Contents - move out then reset
1.00 EA @
45.83 =
45.83
Tear out wet carpet pad and bag for disposal
154.00 SF @
0.43 =
66.22
Tear out wet drywall, cleanup, bag, per LF - up to T tall
6.42 LF @
3.72 =
23.88
Tear out trim
12.00 LF @
0.41 =
4.92
Tear out wet non -salvageable carpet, cut & bag for disp.
154.00 SF @
0.45 =
69.30
Apply plant -based anti -microbial agent
154.00 SF @
0.22 =
33.88
Air mover (per 24 hour period) - No monitoring
8.00 EA @
25.00 =
200.00
Dehumidifier (per 24 hour period) - XLarge - No monitoring
4.00 EA @
103.29 =
413.16
Cleaning - Remediation Technician - per hour
1.00 HR @
47.53 =
47.53
This is prep room for asbestos company.
1.00 HR @
47.53 =
47.53
Negative air fan/Air scrubber (24 hr period) - No monit.
4.00 DA @
77.50 =
310.00
bedroom2 Height: 8'
DESCRIPTION
QTY
UNIT PRICE
TOTAL
Contents - move out then reset
1.00 EA @
45.83 =
45.83
Tear out wet carpet pad and bag for disposal
115.96 SF @
0.43 =
49.86
Tear out wet drywall, cleanup, bag, per LF - up to 2' tall
12.00 LF @
3.72 =
44.64
Tear out trim
12.00 LF @
0.41 =
4.92
Tear out wet non -salvageable carpet, cut & bag for disp.
115.96 SF @
0.45 =
52.18
Apply plant -based anti -microbial agent
115.96 SF @
0.22 =
25.51
Air mover (per 24 hour period) - No monitoring
12.00 EA @
25.00 =
300.00
Dehumidifier (per 24 hour period) - XLarge - No monitoring
4.00 EA @
103.29 =
413.16
Cleaning - Remediation Technician - per hour
1.00 HR @
47.53 =
47.53
This is prep room for asbestos company.
Hallway Height: 8'
DESCRIPTION
QTY
UNIT PRICE
TOTAL
Tear out wet carpet pad and bag for disposal
37.00 SF @
0.43 =
15.91
Tear out wet drywall, cleanup, bag, per LF - up to T tall
5.00 LF @
3.72 =
18.60
Tear out trim
6.00 LF @
0.41 =
2.46
Tear out wet non -salvageable carpet, cut & bag for disp.
37.00 SF @
0.45 =
16.65
Apply plant -based anti -microbial agent
37.00 SF @
0.22 =
8.14
Step charge for remove carpet from steps
13.00 EA @
6.00 =
78.00
Dehumidifier (per 24 hour period) - XLarge - No monitoring
4.00 EA @
103.29 =
413.16
W14 -024109W
9/2/2014
Page: 2
Pro -Care, Inc
CONTINUED - Hallway
DESCRIPTION
QTY UNIT PRICE TOTAL
Cleaning - Remediation Technician - per hour 0.42 HR @ 47.53 = 19.96
This is prep room for asbestos company.
Air mover (per 24 hour period) - No monitoring 4.00 EA @ 25.00 = 100.00
Living Room Height: 8'
DESCRIPTION QTY UNIT PRICE TOTAL
Contents - move out then reset
1.00 EA @
45.83 =
45.83
Tear out wet drywall, cleanup, bag, per LF - up to 2' tall
13.00 LF @
3.72 =
48.36
Tear out trim
22.00 LF @
0.41 =
9.02
Apply plant -based anti -microbial agent
168.00 SF @
0.22 =
36.96
Dehumidifier (per 24 hour period) - XLarge - No monitoring
4.00 EA @
103.29 =
413.16
Air mover (per 24 hour period) - No monitoring
12.00 EA @
25.00 =
300.00
Tear out wet drywall, cleanup, bag for disposal
11.42 SF @
0.80 =
9.14
This is for ceiling
Negative air fan/Air scrubber (24 hr period) - No monit.
4.00 DA @
77.50 =
310.00
Tear out non-salv solid/eng. wood flr & bag for disposal
40.00 SF @
2.46 =
98.40
Cleaning - Remediation Technician - per hour
1.42 HR @
47.53 =
67.49
This is prep room for asbestos company.
living Room/closet Height: 8'
DESCRIPTION QTY UNIT PRICE TOTAL
Tear out wet drywall, cleanup, bag, per LF - up to T tall
29.50 LF @
3.72 =
109.74
Apply plant -based anti -microbial agent
10.47 SF @
0.22 =
2.30
Air mover (per 24 hour period) - No monitoring
4.00 EA @
25.00 =
100.00
Tear out non-salv solid/eng. wood flr & bag for disposal
13.00 SF @
2.46 =
31.98
Cleaning - Remediation Technician - per hour
0.17 HR @
47.53 =
8.08
This is prep room for asbestos company.
Kitchen Height: 8'
W14 -024109W 9/2/2014 Page:3
Pro -Care, Inc
DESCRIPTION
QTY
UNIT PRICE
TOTAL
Contents - move out then reset
1.00 EA @
45.83 =
45.83
Tear out trim
6.00 LF @
0.41=
2.46
Apply plant -based anti -microbial agent
117.00 SF @
0.22 =
25.74
Air mover (per 24 hour period) - No monitoring
12.00 EA @
25.00 =
300.00
Tear out wet drywall, cleanup, bag for disposal
36.00 SF @
0.80 =
28.80
This is for ceiling
4.00 EA @
103.29 =
413.16
Tear out wet drywall, cleanup, bag - Cat 3
50.00 SF @
1.68 =
84.00
This is for 8/5/14
Plumber - per hour
4.00 HR @
106.61=
426.44
Detach faucett,disposal,dishwasher and gas stove.
8.00 SF @
0.80 =
6.40
Tear out and bag wet insulation - Category 3 water
50.00 SF @
1.28 =
64.00
This is for 8/5/14
3.00 LF @
3.72 =
11.16
Negative air fan/Air scrubber (24 hr period) - No monit.
1.00 DA @
77.50 =
77.50
This is for 8/5/14
Dehumidifier (per 24 hour period) - XLarge - No monitoring
4.00 EA @
103.29 =
413.16
This is for 8/5/14
Air mover (per 24 hour period) - No monitoring
6.00 EA @
25.00 =
150.00
This is for 8/5/14
HEPA Vacuuming - Detailed - (PER SF)
35.00 SF @
1.01 =
35.35
This is for 8/5/14
Apply plant -based anti -microbial agent
52.00 SF @
0.22 =
11.44
This is for 8/5/14
Cabinetry - lower (base) units - Detach & reset
7.25 LF @
46.84 =
339.59
This is for 8/5/14
Cabinetry - upper (wall) units - Detach & reset
6.67 LF @
40.06 =
267.20
This is for 8/5/14
Dehumidifier (per 24 hour period) - XLarge - No monitoring
4.00 EA @
103.29 =
413.16
Cleaning - Remediation Technician - per hour
1.42 HR @
47.53 =
67.49
This is prep room for asbestos company and move kitchen cabinets to
basement.
Tear out non-salv vinyl, cut & bag - Category 3 water
117.00 SF @
1.45 =
169.65
basement stairs Height: 8'
DESCRIPTION QTY UNIT PRICE TOTAL
Air mover (per 24 hour period) - No monitoring
4.00 EA @
25.00 =
100.00
Tear out wet drywall, cleanup, bag for disposal
8.00 SF @
0.80 =
6.40
This is for ceiling
Tear out wet drywall, cleanup, bag, per LF - up to 2' tall
3.00 LF @
3.72 =
11.16
Apply plant -based anti -microbial agent
30.00 SF @
0.22 =
6.60
W14 -024109W 9/2/2014 Page:4
Pro -Care, Inc
Basement Height: 8'
DESCRIPTION QTY UNIT PRICE TOTAL
Tear out wet non -salvageable carpet, cut & bag for disp.
220.00 SF @
0.45 =
99.00
Tear out wet carpet pad and bag for disposal
220.00 SF @
0.43 =
94.60
Tear out wet drywall, cleanup, bag, per LF - up to 2' tall
19.00 LF @
3.72 =
70.68
R&R Acoustic ceiling tile
22.00 SF @
3.44 =
75.68
Apply plant -based anti -microbial agent
220.00 SF @
0.22 =
48.40
Dehumidifier (per 24 hour period) - XLarge - No monitoring
4.00 EA @
103.29 =
413.16
Air mover (per 24 hour period) - No monitoring
20.00 EA @
25.00 =
500.00
Negative air fan/Air scrubber (24 hr period) - No monit.
4.00 DA @
77.50 =
310.00
Miscellaneous
DESCRIPTION QTY UNIT PRICE TOTAL
Emergency service call - during business hours
1.00 EA @
133.09 =
133.09
Equipment setup, take down, and monitoring (hourly charge)
8.00 HR @
47.53 =
380.24
Haul debris - per pickup truck load - including dump fees
4.00 EA @
181.39 =
725.56
Equipment setup, take down, and monitoring (hourly charge)
6.00 HR @
47.53 =
285.18
This is for 8/5/14
Haul debris - per pickup truck load - including dump fees
1.80 EA @
181.39 =
326.50
This is for 8/5/14
Add for HEPA filter (for negative air exhaust fan)
3.00 EA @
189.49 =
568.47
Residential Supervision / Project Management - per hour
8.00 HR @
61.31 =
490.48
Add for personal protective equipment - Heavy duty
12.00 EA @
17.33 =
207.96
This is for 3 tech/2xday
Grand Total Areas:
2,520.00 SF Walls
852.43 SF Floor
0.00 SF Long Wall
852.43 Floor Area
3,027.00 Exterior Wall Area
0.00 Surface Area
0.00 Total Ridge Length
852.43 SF Ceiling
94.71 SY Flooring
0.00 SF Short Wall
960.99 Total Area
336.33 Exterior Perimeter of
Walls
0.00 Number of Squares
0.00 Total Hip Length
3,372.43 SF Walls and Ceiling
315.00 LF Floor Perimeter
315.00 LF Ceil. Perimeter
2,520.00 Interior Wall Area
0.00 Total Perimeter Length
W14 -024109W 9/2/2014 Page:5
Pro -Care, Inc
Line Item Total
Material Sales Tax
Replacement Cost Value
Net Claim
Summary
David Andrs
Emergency Manager
12,236.66
62.64
$12,299.30
$12,299.30
W14 -024109W 9/2/2014 Page:6
/ -I .+m DATE (MMIDD/YYYY)
4e-'"�2r.� CERTIFICATE OF LIABILITY INSURANCE n7, v, n14
T IFICATE 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
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
ms and conditions of the policy, certain policies may require and endorsement. A statement on this certificate does not confer rights to the
Aificate holder in lieu of such endorsement(s).
-PRODUCER 4,CONTACT
WT PHELAN
NAME:
PHONE FAX
I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: I
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
E-MAIL
ARLINGTON, MA 02476
ADDRESS:
26T6C
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED
L
INSURER A: AMERICAN ZURICH INSURANCE COMPANY
PROCARE INC & PROCARE PLUMBING AND HEATING
(MMIDDIYYYY)
INSURER B:
CORPORATION
INSURER C:
INSURER D:
3 NORTH MAPLE STREET
EACH OCCURRENCE
$
INSURER E:
WOBURN, MA 01801
INSURER F:
I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: I
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
ADD
SUB
POLICY EFF DATE
POLICY EXP DATE
LTR
TYPE OF INSURANCE
I
L
R
POLICY NUMBER
(MMIDDIYYYY)
(MMIDDIYYYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE aOCCUR.
PPERSONAL
TO RENTED
PREMISES (Ea occurrence)
$
ED EXP (Any one person)
$
&ADV INJURY
$
—
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY F] PROJECT ❑LOC
ENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
AUTOMOBILE LIABIUTY
COMBINED SINGLE
$
ANY AUTO
LIMIT (Ea accident)
BODILY INJURY
$
ALL OWNED AUTOS
SCHEDULE AUTOS
(Per person)
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
$
(Per accident)
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS -MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
AWORKER'S COMPENSATION AND X wC STATUTORY OTHER
EMPLOYER'S LIABILITY YIN UB -5B510888-14 08/02/2014 08/02/2015 LIMITS
ANY PROPERITOR/PARTNER/EXECUTIVE FN7-1 N/A E. L. EACH ACCIDENT $ 1,000,000
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000 000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE
"ERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
IN ACCORDANCE WITH THE POUCY PROVISIONS.
AUTHORIZED REPR TA. E :.
25 (2010105) The ACORD name and logo are registered marks of ACORD
Massachusetts - Department of Public Safety
Board of Building Regulations and Standards
Construction Supenisor
License:. CS-061789
j PAUL.M MELANSbN
402 FERRY ST t
EVERETT MA 631491
J.�..• Jj.'r�'�,� Expiration -,
Commissioner 09/15/2015
C���ie tOdn�nonu�ea,C� o�Cii�acluaeC7a-
Office of Consumer Affairs & Business Regulation License or registration valid for individul use only
OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
Registratiow 2-2M-.5 Type: -10 Park Plaza Suite 5170
Expirati'on;{b/�6 Supplement ward Boston, MA 02116
PRO -CARE INC
PAUL MELANSON;,
3 NORTH MAPLE ST
WOBURN, MA 01801
Undersecretary
Not valid without signature
N