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Home My WebLink AboutBuilding Permit #697 - 557 SHARPNERS POND ROAD 6/15/2009BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this.page a ' `LOCATION 3S M Po • Priv 'PROPERTY -OWNER, &y ry ,. % .i e- h e Ls Print MAP NO: '8'_.PARC-EL:1 ZONING DIST,RIC ' Historic District yes no Machine,Shop Village, yes, no TYPE OF IMPROVEMENT 0- YX PROPOSED USE Residential Non- Residential New Building < ne famil Addition Two or more family Industrial Alteration No. of units: Commercial epai , placement Assessory Bldg Others: emolition Other Septic Well,'- W = Floodplain 'Wetlands 1Natershed'Dstrict Water/Sewer- ater/Sewer 0-YX D iO 6— % 0 OWNER: Name: li7ew DESCRIPTION OF WORK TO BE PREFORMED: f&a rkt W a, I I� Aki I Floa r) t) 6 Please Type or Print Clearly) Phone: o" . _ t CONTRACTOR .Name: i' GV�o`Qy'/iPhone. lk-i✓- Address: Azyew '1 / Z, Supervisor's Con struction`License: } Exp. Date: ..:� a :3;L �� Home Improveriieni'L�cense. 1`43 70k- txp. ,Date: �l �t � Q 01/10 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: $ 4 FEE: $ 60 Check No.: Receipt No.: �Zo2/I % NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 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 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: Comm Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: 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 Doc.Building Permit Revised 2008 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/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 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location-Ss�i > /!G✓�.��/�/1 Da�►/r/ No.- Date4 TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ y�ss+cNustt� Building/Frame Permit Fee $ �— Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Ir 22117 Building Inspector M rA rA t., as u O LE Cf) LL cn O A .� Ga O w° p � C U Cd G w O PO � O a: . C w O w w :,-E O w � i r w O O a4 G W w w� 7 z t w cn D cn O H n Oft ui z p_ . c o m c c. O C .. O n m • ty ea 0 m a :mCE CL y E c Cc .. ca S m . :mm oV m M-0 �+ y c0 . � y COD y m m z c c h Q aCt �m o� y O mcc.), Z d Q m y m C = m O. O h r gas m W CO z o... C = m •� .y dt O C _ LU CD COD D. m� O� = R � v N = _ CL.- Cc J O i..l A., 0 L O v Z O O H C C co r ca co I Q �. eMO MMO W W a— i C3. _ .0.0 = O � y-- 3 a� CD L CC O d CL CMQ S cc w J .v FL 43 CO3 Z C3 CD C.3 y C C _cc Q. y 0 0 U) uj U) W W W W \ ` / Mxxxohu+,,ts D,yxr,m,utof' Public 5:6t! Board of' BviWiouRc�/|ution*and stxudx,dy Construction Supervisor License License: co nrnoz Restricted to: 00 DAVID MART 23OESSEX ST/PO BOX 1723 MAVERH(LL. MA 01831 svpnmwn: 5/23m00 Tr#: 26944 � , Board of Building Regulations and Standard HOME IMPROVEMENT CONTRACTOR � Registration: 1*3708 � sxno 010 nw 271833 � DBA SERvPR0Or*AVERH|L4 DAVID HART unoESSEX STREET HAVEnH0`wmO1830 Administrator AUTHORIZATION TO PERFORM SERVICES and • DIRECTION OF PAYMENT The undersigned client, being the building owner, owner's representative, or resident, authorizes the Provider identified below to perform any and all necessary cleaning and/or restoration services on Client's property located at the property address below, and with respect to items that need to be cleaned at a remote location to remove and clean such items as necessary. Client authorizesC'Insurance Company, herein referred to as "Insurance Company," to pay Provider solely land directly for that portion of the work covered by Client's insurance policy. If, for any reason, Client receives a check from Insurance Company made payable to Client, Client agrees to pay Provider immediately upon receipt of the check. In order to expedite payment to Provider, Client hereby appoints Provider as attorney-in-fact, authorizing Provider to endorse Client's name on Insurance Company checks or drafts, and to deposit Insurance Company checks or drafts for Provider services. Client agrees to pay Client's deductible in the amount of $ that applies to this claim. If any amounts owing to Provider for Provider services are not covered by insurance, Client agrees to pay those amounts to Provider within fifteen (15) days of Client's receipt of invoice. It is fully understood that Client and its agents, successors, assigns and heirs are personally responsible for any and all deductibles and any costs not covered by insurance. Interest and finance charges will be charged at the maximum allowable by law, or at 1.5% per month, whichever is less, on accounts over thirty (30) days past due. Time is of the essence. Client agrees that Provider is working for the Client and not Client's insurance company or any agent/adjuster. Remarks: Property Owned by: I have read this Authorization to Perform Services and Direction of Payment, including the Terms and Conditions of Service on the reverse side hereof, and agree to same. Client's Signature Date Printed Name Franchise Legal Name 1� qS S�eiCQY`e Pc'�� „� (Je6poration, ( ) LLC, () partnership, () LLP, () sole proprietorship Address �t�t�LZya�`��ni� d/b/a SERVPRO®ofAA1fS&,j-Q��1 SERVPRO° Franchises are independently owned and operated. White — SERVPROO Yellow — Adjuster Pink — Customer 28000 Revised 08/07 Each SERVPRO® Franchise is Independently Owned and Operated RESTORATION RRG A Risk Retention Group Home Office 2999 North 44`h Street, Suite 250 Phoenix, AZ 85018 (602)266-1166 Branch Office 3605 Glenwood Avenue, Suite 190 Raleigh, NC 27612 (866)249-0293 NOTICE: THIS POLICY IS ISSUED BY YOUR RISK RETENTION GROUP, YOUR RISK RETENTION GROUP MAY NOT BE SUBJECT TO ALL OF THE INSURANCE LAWS AND REGULATIONS OF YOUR STATE. STATE INSURANCE INSOLVENTY GUARANTEE FUNDS ARE NOT AVAILABLE FOR YOUR RISK RETENTION GROUP. Policy Number: RGLO50012 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Named Insured: Home & Auto Professional Services, Inc. Effective Date: 03/01/09 Agent Name: BB&T Insurance Services, Inc. 12:01 A.M. Standard Time Agent No. 101 LIMIT OF INSURANCE EACH OCCURRENCE LIMIT $ 1,000,000 DAMAGE TO PREMISES RENTED TO YOU LIMIT $ 100,000 Any one -premises MEDICAL EXPENSE LIMIT $ 5,000 Any one person PERSONAL & ADVERTISING INJURY LIMIT $ 1,000,000 Anyone person or organization GENERAL AGGREGATE LIMIT $ 2,000,000 PRODUCTS/COMPLETED OPERATIONS AGGREGATE LIMIT $ 2,000,000 Retroactive Date (CG 00 02 ONLY) This insurance does not apply to "bodily injury" or "property damage" which occurs before the Retroactive Date, if any, shown here: Enter Date or "None" if no Retroactive Date a lie Description of Business and All Premises You Own Rent or Occupy Form of Business: ❑ Individual ❑ Partnership ❑ Joint Venture ❑ Limited Liability Company ® Organization, including a Corporation (but not including a Partnership, Joint Venture or Limited Liability Company) Business Description: Disaster Restorations Location of All Premises You Own, Rent or Occupy: 230 Essex St, Haverhill, MA 01832 Forms and Endorsements.. Form(s) and Endorsement(s) applying to this Coverage Part and made a part of this policy at time of issue: Classification and Premium Classification State Tax of Other (if applicable) $ Total Premium (Subject to Audit) $ 4,970 Premium Shown is Payable: at inception $ Audit Period (if applicable): Countersigned: March 11, 2009 By: (Date) (Authorized Representative) Turnr n�� - UMULAKA I IUNS, I UGETHER WITH THE COMMON POLICY CONDITIONS AND COVERAGE FORM(S) AND ANY ENDORSEMENT(S), COMPLETE THE ABOVE NUMBERED POLICY. Includes copyrighted material of Insurance Services Office, Inc., with its permission. Copyright, Insurance Services Office, Inc., 1998 RGL 2000 (01/05) Company Copy A WCIP dSSUING OFFICE 181 ;INFORMATION PAGE Workers Compensation and Enwlovers Liabilitv Poliev ACCOUNT NO. SUB ACCT NO. Liberty Mutual Insurance Group/Boston 1-368163 0000 LIBERTY MUTUAL FIRE INSURANCE CO 16586 POLICY NO. TD/CD SALES OFFICE CODE SALES CODE NIR IST WC2-31S-368163-018 XX X WESTON 102 REPRESENTATIVE 3000 1 YEAR ..JASSIGNED 2008 Item 1. Name of HOME & AUTO PROFESSIONAL SERVICES INC Insured Address 230 ESSEX STREET HAVERHILL, MA 01830 Status 03 - CORPORATION FEIN 04-2887465 RISK ID 102470 Other workplaces not shown above: SEE ITEM 4 Mo. Day Year Mo. Day Year Item 2. Policy Period: From 08-19-2008 to 08-19-2009 12:01 AM standard time at the address of the insured as stated herein. Item 3. Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident 500,000 each accident Bodily Injury by Disease 500,000 policy limit Bodily Injury by Disease 500,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE END WC 20 03 06A D. This policy includes these endorsements and schedules: SEE EXTENSION OF INFORMATION PAGE Item 4. Premium - The premium for this policy will be determined by our Manuals of Rules Classifications Rates and Rating Plans. All information required below is subject to verification and change by andir lvilnimum rrenuum ) auu ( MA ) Total hstimated Annual Premium $ 13,212 Interim adjustment of premium shall be made: ANNUAL This policy, including all endorsements issued therewith, is hereby countersigned by Authorized Representative Date 08-28-08 Loc. Code I Term. Oper. Audit Basis Periodic Payment I Rating Basis Pol. H.G. I Home State Dividend r 08-28-08 1 NR I MA NEW GPO 4030 R1 Copyright 1987 National Council on Compensation Insurance WC 00 00 01 A Insured Copy Premium Basis Rates LINE 110 Per $100 Estimated Classifications Code Estimated of RE- Annual No. Total Annual Premiums muneration Premiums SEE EXTENSION OF INFORMATION PAGE lvilnimum rrenuum ) auu ( MA ) Total hstimated Annual Premium $ 13,212 Interim adjustment of premium shall be made: ANNUAL This policy, including all endorsements issued therewith, is hereby countersigned by Authorized Representative Date 08-28-08 Loc. Code I Term. Oper. Audit Basis Periodic Payment I Rating Basis Pol. H.G. I Home State Dividend r 08-28-08 1 NR I MA NEW GPO 4030 R1 Copyright 1987 National Council on Compensation Insurance WC 00 00 01 A Insured Copy % Pistone Contail!I�! 4 Kashmir Dr. Salem, NH 03079 • Tel.: 603-234-8001 Fax: 978-372-8310 SERVPRO OF HAVERHILL 230 ESSEX ST HAVERHILL, MA 01830 9783748555 Invoice • CUSTOMER ORDER NO. DATE PAGE 10/14/2008 SERVPRO OF HAVERHILL 153 Liberty Street Haverhill, MA 01832 PO NO. TERMS SALESPERSON SHIP VIA SHIP DATE FOB ITEM QUANTITY UNIT DESCRIPTIONAMOUNT 10R01.5T2wk 1.00 10 Yard Roll Off 1.5 Ton Max/2weeks $406.25 $406.25 SURCHARGE 1.00 Gas surcharge- 5.00% X $20.31 $20.31 12-15 $426.56 $0.00 $0.00 $426.56 $0.00 $426.56 Client: Barry Eisenberg Home: 557 Sharpners Pond Road North Andover, MA 01845 Operator Info: Operator: BCARIFIO Estimator: Brian Carifio Reference: Company: Fred Newell Type of Estimate: Other Date Entered: 6/4/2009 Date Assigned: 6/2/2009 Date Est. Completed: 6/4/2009 Date Job Completed: Price List: MAB05B APR09 Restoration/Service/Remodel Estimate: EISENBERG Cellular: (978) 804-5428 i EISENBERG DESCRIPTION EISENBERG QNTY REMOVE REPLACE TOTAL 1. Equipment setup, take down, and 3.00 HR- 0.00 41.98 125.94 monitoring (hourly charge) time for estimator to visit site, meet with customer, create scope, review scope with crew, reinspect job, pickup equipment at completion 16. Containment Barrier/Airlock/Decon. 172.00 SF 2. Add for personal protective equipment 8.00 EA 0.00 10.90 87.20 (hazardous cleanup) containment over opening leading to kitchen and flooring for protective purposes 3. Respirator cartridge - HEPA only (per 8.00 EA 0.00 8.29 66.32 pair) 0.00 97.10 disposal 4. Negative air fan/Air scrubber (24 hr 4.00 DA 0.00 71.08 284.32 period) - No monit. 0.00 38.31 19. HEPA Vacuuming - Detailed - (PER 607.49 SF Total: EISENBERG 563.78 dining Missing Wall: 1 - 107" X 6'8" Missing Wall: 1 - 412" X 618" DESCRIPTION Main Level 338.67 SF Walls 475.49 SF Walls & Ceiling 14.67 SY Flooring 46.80 LF Ceil. Perimeter Opens into family Opens into kitchen QNTY REMOVE Ceiling Height: Sloped 136.82 SF Ceiling 132.00 SF Floor 31.25 LF Floor Perimeter Goes to Floor Goes to Floor REPLACE TOTAL 15. Content Manipulation charge - per 1.50 HR 0.00 35.56 53.34 hour move room content prior to demo and return after work done 16. Containment Barrier/Airlock/Decon. 172.00 SF 0.00 0.62 106.64 Chamber containment over opening leading to kitchen and flooring for protective purposes 17. Tear out wet drywall, cleanup, bag for 118.41 SF 0.82 0.00 97.10 disposal 18. Tear out and bag wet insulation 68.41 SF 0.56 0.00 38.31 19. HEPA Vacuuming - Detailed - (PER 607.49 SF 0.00 0.53 321.97 SF) 20. Clean more than the walls and ceiling 607.49 SF 0.00 0.29 176.17 21. Apply anti -microbial agent 118.41 SF 0.00 0.23 27.23 Totals: dining 820.76 EISENBERG 6/12/2009 Page:2 family Missing Wall: 1- 15'1" X 6'8" Missing Wall: 1- 107" X 6'8" DESCRIPTION 482.56 SF Walls 699.62 SF Walls & Ceiling 18.94 SY Flooring 59.01 LF Ceil. Perimeter Opens into living Opens into dining QNTY Ceiling Height: Sloped 217.06 SF Ceiling 170.50 SF Floor 27.33 LF Floor Perimeter Goes to Floor Goes to Floor REMOVE REPLACE TOTAL 5. Content Manipulation charge - per hour 1.50 HR 0.00 35.56 53.34 move room content to adjacent room, then move back at completion 6. Containment Barrier/Airlock/Decon. 420.50 SF 0.00 0.62 260.71 Chamber contain open walls and flooring for protective purposes 7. Tear out trim/base and bag for disposal 16.00 LF 0.77 0.00 12.32 8. Tear out wet drywall, cleanup, bag for 148.53 SF 0.82 0.00 121.79 disposal 9. Tear out and bag wet insulation 148.53 SF 0.56 0.00 83.18 10. HEPA Vacuuming - Detailed - (PER 870.12 SF 0.00 0.53 461.16 SF) 11. Clean more than the walls and ceiling 742.24 SF 0.00 0.29 215.25 13. Clean and deodorize carpet 127.88 SF 0.00 0.38 48.59 14. Apply anti -microbial agent 148.53 SF 0.00 0.23 34.16 34. Negative air fan/Air scrubber (24 hr 2.00 DA 0.00 71.08 142.16 period) - No monit. Totals: family 1,432.66 Missing Wall: Missing Wall: living 266.11 SF Walls 493.28 SF Walls & Ceiling 25.24 SY Flooring 45.83 LF Ceil. Perimeter 1- 14'6" X 0'0" Opens into kitchen 1- 15'1" X 6'8" Opens into family Ceiling Height: 8' 227.17 SF Ceiling 227.17 SF Floor 30.75 LF Floor Perimeter Goes to Floor/Ceiling Goes to Floor EISENBERG 6/12/2009 Page:3 DESCRIPTION QNTY REMOVE REPLACE TOTAL 22. Clean floor 113.58 SF 0.00 0.38 43.16 after movement of content and trafficking Totals: living 43.16 kitchen Ceiling Height: 8' 322.89 SF Walls 212.67 SF Ceiling 535.56 SF Walls & Ceiling 212.67 SF Floor 23.63 SY Flooring 39.67 LF Floor Perimeter 43.83 LF Ceil. Perimeter Missing Wall: 1 - 14'6" X 0'0" Opens into living Goes to Floor/Ceiling Missing Wall: 1 - 412" X 618" Opens into dining Goes to Floor DESCRIPTION QNTY REMOVE REPLACE TOTAL 23. Clean floor. 106.33 SF 0.00 0.38 40.41 after movement of adjacent room content and trafficking Totals: kitchen 40.41 Total: Main Level 2,336.99 i garage 1 1 DESCRIPTION 24. Content Manipulation charge - per hour move content to adjacent bay 25. Containment Barrier/Airlock/Decon. Chamber EISENBERG basement Ceiling Height: 8' 768.00 SF Walls 495.00 SF Ceiling 1,263.00 SF Walls & Ceiling 495.00 SF Floor 55.00 SY Flooring 96.00 LF Floor Perimeter 96.00 LF Ceil. Perimeter QNTY REMOVE REPLACE TOTAL 3.00 HR 0.00 35.56 106.68 200.00 SF 0.00 0.62 124.00 6/12/2009 Page:4 DESCRIPTION containment of bay from remainder of garage CONTINUED - garage QNTY REMOVE REPLACE TOTAL 26. Tear out wet drywall, cleanup, bag for 90.00 SF 0.82 0.00 73.80 disposal 27. Tear out and bag wet insulation 90.00 SF 0.56 0.00 50.40 28. HEPA Vacuuming - Detailed - (PER 1,758.00 SF 0.00 0.53 931.74 SF) 29. Clean more than the ceiling 879.00 SF 0.00 0.29 254.91 31. Clean the floor with pressure steam 495.00 SF 0.00 0.75 371.25 32. Apply anti -microbial agent 90.00 SF 0.00 0.23 20.70 33. Negative air fan/Air scrubber (24 hr 2.00 DA 0.00 71.08 142.16 period) - No monit. Totals: garage 2,075.64 Total: basement 2,075.64 Line Item Totals: EISENBERG 4,976.41 Grand Total Areas: 2,178.22 SF Walls 1,237.33 SF Floor 0.00 SF Long Wall 1,237.33 Floor Area 1,769.56 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length 1,288.72 SF Ceiling 137.48 SY Flooring 0.00 SF Short Wall 1,320.61 Total Area 213.67 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length 3,466.94 SF Walls and Ceiling 225.00 LF Floor Perimeter 291.48 LF Ceil. Perimeter 2,178.22 Interior Wall Area 0.00 Total Perimeter Length EISENBERG 6/12/2009 Page:5 Line Item Total Replacement Cost Value Net Claim Brian Carifio Summary 4,976.41 $4,976.41 $4,976.41 EISENBERG 6/12/2009 Page:6 Recap by Room Estimate: EISENBERG Area: Main Level dining family living kitchen Area Subtotal: Main Level Area: basement garage Area Subtotal: basement Subtotal of Areas Total EISENBERG 563.78 11.33% 820.76 16.49% 1,432.66 28.79% 43.16 0.87% 40.41 0.81% 2,336.99 46.96% 2,075.64 41.71% 2,075.64 41.71% 4,976.41 100.00% 4,976.41 100.00% 6/12/2009 Page:7 c Recap by Category Items CLEANING CONTENT MANIPULATION GENERAL DEMOLITION WATER EXTRACTION & REMEDIATION Total Dollars % 1,149.74 23.10% 213.36 4.29% 476.90 9.58% 3,136.41 63.03% Subtotal 4,976.41 100.00% EISENBERG 6/12/2009 Page:8