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HomeMy WebLinkAboutBuilding Permit #146-14 - 51 NUTMEG LANE 8/15/2013 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: I"I Date Received Date Issued: ✓ IS 1 IMPORTANT:Applicant must complete all items on this page LOCATION S � N `-* Print PROPERTY OWNER GhfRyt+j Print 100 Year Old Structure yes Cn� MAP NO: y 3 PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yesnD TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building '6 One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District 16Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: V—as¢-e J- b a-T L, Identification Please Type or Print Clearly) OWNER: Name: Phone: �.2i 3 Address: S L N CONTRACTOR Name: �< e =. ✓ •a Phone: 1,,?* S 3 3 5 Address: `k.q5 PUA,.-e S-t-11 ..._t— Supervisor's Construction License: Q5 3 U 1", Exp. Date: 6 t 1`I Home Improvement License: vox 'B '-1.`'l Exp. Date: I, 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: $ Z513 ll Q FEE: $ .3 a�A l cQ134 Check No.: � � Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Ovvne _ �A�,Signature of contractor L� Plans Submitted ❑ Plans Waived'S Certified Plot Plan 11 Stamped Pla s Plans Submitted ❑ Plans Waive Certified Plot Plan ❑ Stamped Plans ❑ I� I TYPE-OF.SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/SaIes ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED I PLANNING & DEVELOPMENT ❑ ❑ 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 DPW ToNv2 Engineer: Signature: Located 384 OsqooStreet FIRE 1DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main'Street Fire Deparfinefit signatureldate 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 - Date i [ Doc.Building Permit Revised 2010 Building Department Tine folowing is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofirg, 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/Crossection/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 api)%-al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must bf- submitted with the building application Doc: Doc.Bui!ding permit Revised 2012 Location 5 I ' t C L11 .' No. Date . - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ "Er Building/Frame Permit Fee $NJON ON Foundation Permit Fee $ Other Permit Fee; $ TOTAL $ Check#4. ►u Building Inspector Enter construction cost for fee cal- North Andover Fee Cakulation Construction Cost $ 253300.00 m $ - $ 303.60 Plumbing Fee $ 37.95 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 37.95 Total fees collected $ 479.50 51 Nutmeg Lane 146-14 on 8/15/2013 Remodel Master Bath • 98 Forest Street • North Andover,MA 01845 • PH:978-688-5335 B u l ld l tor FAX:978-688-7207 Proposal To: Patrick Garvin 51 Nutmeg Lane 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: 1/30/2013 Job: Bathroom Renovation Date of plans: None Architect: None 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 3/1/13. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 4/30/13.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 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. I Section III-Scope of Work Page 1 of 4 �(� Page 2 of 4 98 Forest_S° eet North Andover.MA 01845 General Proposal is to renovate exisitng master bathroom. Building permit will be obtained by contractor. Demolition Existing tile floor and underlayment will be removed. Shower will be completely gutted,tile on deck of jacuzzi will be removed. Existing vanities / cabinets will be removed. No allowance has been made to completely gut bathroom. Building Any miscellaneous materials required to renovate bathroom will be provided by contractor. Plumbing Plumbing labor/minor materials required to renovate bath will be provided. New copper pan for shower will be supplied and installed.All plumbing fixtures to be provided by owner. Electrical Electrical work required for renovation will be provided. New Panasonic bath fan / light will be supplied and installed.All other surface mounted fixtures to be provided by owner. Plaster Any plastering/patching will be provided. Interior Trim/Doors Any interior trim required will be supplied / installed by contractor. No allowance has been made for any door units. New vanities/cabinets to be supplied by owner, installed by contractor. Flooring New tile floor, shower, and jacuzzi deck will be installed. All labor/adhesives/ miscellaneous materials will be will be provided.Tile materials to be supplied by owner. Painting All interior painting will be provided. One coat of primer and two coats of finish will be applied to all painted surfaces. Waste Removal All demolition/construction debris will be disposed of by contractor. Other Allowances An allowance of$2000 has been included to supply and install new frameless shower door. a Page 3 of 4 98 Forest S m! North Andover.MA 01845 a Page 4 of 4 98 Forest North Andover.MA 01845 Section N-Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ... ... ... ... ... ... ... ... ... ....$ 15,300 Payment to be made as follows: Percentage/item Description Amount 1 Permit obtained / demolititon complete $5000 2 Tile installation complete $5000 3 Job 100% complete $5300 I Total 3 ---T$15,300.00 "Notice:No agreement for Home improvement contracting work shall require a dam 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 3 b � Signature Date OORTH Town of t E ndover Ih ver, Mass V► 15a 201 COC NIC HI WICK y1. A04ATEo PPP��(y S u BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System • THIS CERTIFIES THAT ........................ BUILDING INSPECTOR ...... �,..... .. ... .4�.l�. ..... ................... . . .. . .. .... has permission to erect ..... buildings on Foundation .................. ....61...... ..... .. ... .+. . ...L... ... ��� Rough to be occupied as .......r4 .............................................. Chimney ...... . . .. ......1211. provided that the person accepting this permit shall in every respect conform to the terms of the application 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 CONSTRU STAT Rough ervice .:....... . .................................................................... 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. SEE REVERSE SIDE The Commonwealth of Massachusetts Ln Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Hanle(Business/Organization/Individual): � �1 Address: �Z 6 �—t City/State/Zip: 1\,/ . A—4�,, (, U\-- )Phone#: Are you an employer?Chectthe appropriate box: Type of project(required): 1.fig am a employer with 4• ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El 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 10.❑Electrical repairs or additions required.] officers have exercised their 3.E] 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 t employees.[No workers' insurance required] l13.0 Other comp.insurance required.] *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 their workers'comp.policy information. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ) L G/ Policy#or Self-ins.Lie.M VL- �"''�- 2Z�"(b Expiration Date: Job Site Address: L ��-'� �^�-; ��° City/State/Zip: C�,&.. th� 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 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 certunder the pains and penalties of perjury that the information provided above is true and correct. Sip-nature- Date: Phone# S'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): I.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: A��® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 7/17/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: M P ROBERTS INS AGCY INC PHONEFAX we ND ext: (978) 683-8073 AIC,N.):(978) 683-3147 1060 Osgood Street ADRESS:sandi@mprobertsinsurance.com North Andover, MA 01845 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: PROVIDENCE MUTUAL INSURED KEVIN MURPHY BUILDING & REMODELING INSURER B:MERCHANTS INSURANCE 169 BOXFORD STREET INSURER C:GUARD INSURANCE NORTH ANDOVER, MA 01845 INSURER D: INSURER E INSURER F: 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 THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY E POLICY EXP LIMITS LTR wsD WVD POLICY NUMBER MM/DD/YYYY /Y MM/DDYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 _L UHEN CLAIMS-MADE CI OCCUR PREMISES Ea occurrence $ 500,000 MED EXP(Any one person) $ 15,000 A BOPI068945 11/22/12 11/22/13 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY CI PRO F JO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGI7rCVrf__ Ea accident $ 1,000,000 ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED MCA7013608 01/23/13 01/23/14 B AUTOS X AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 CUP9145304 11/22/12 11/22/13 DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN X I STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500 000 C+ OFFICER/MEMBER EXCLUDED? CI N/A (Mandatory in NH) KEWC422467 07/01/13 07/01/14 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 L I — I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE BUILDING DEPT. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESEWAIW E ©1988-2013 ACORD CORPORATION. All rights reserved. ACORD25(2013/04) The ACORD name and logo are registered marks of ACORD