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HomeMy WebLinkAboutBuilding Permit #1074-15 - 59 BERRINGTON PLACE 6/18/2015 (0�774< bUILUINU I'tKMI I TOWN OF NORTH ANDOVER ; A �L S f r APPLICATION FOR PLAN EXAMINATION Zo 4 Permit N0: Date Received n9 1 �9t Date Issued: -TS IMPORTANT:Applicant must complete all items on this page `� i LOCATION :59 &—af eA (SDR--rh f r� k Print PROPERTY OWNER M I cls QCT–re-g- ggwilr'� t a4j ( 6 ' Prim �— MAP NO:O37. PARCEL:6 10 ZONING DISTRICT: Historic District yesnno Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building X One family ❑Addition ❑ Two or more family ❑ Industrial KAlteration No. of units: ❑ Commercial K Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Septic ❑ Well ❑ Floodplain ❑Wetlands ❑.Watershed District IZ Water/Sewer ;,1 1 fox e ►�� la<<� �� — s�� 'ey Identification Please Type or Print Clearly) OWNER: Name: ELftr4 P-7`t�i G h'IIC,�}FZL,E I bone: -\4 i O -9 3 Address: �� `��1'z ► i (D� �( �� CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Horne Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. M. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ I n0 0E-)C7 FEE: $ �W Check No.: Receipt No.: ; NOTE: Persons contra n ith unregistered contractors do not have access tot a guaranty fund -, Signature of Aggnt/Owner Signature of contractor r NORTH BUILDING PERMIT Q�(tUFD /6A"o a` TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 'Qp Permit No#: Date Received �s1s AATfD 0��4`� SgcHUs Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: 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 ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other _ ❑ Septic , pi Welt^ tloodplai:n Wetlands D Watershed District Writer/.5'gwer. DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email Address: Supervisor's Construction License: Exp. Date: - Home Improvement License: Exp. Date: 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: $ FEE: $ r Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Location No. Date • • TOWN OF NORTH ANDOVER . s D • .` .ti Certificate of Occupancy $ � Building/Frame Permit Fee $ - Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 26547 Building Inspector 6 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ d L 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 Reviewed on Signature COMMENTS i 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 Town Engineer: Signature: . a 0 Located 384 Osgood Street FIREEPARTMENT Temp ®uNPA teron situ yes n© Loi sated 12 Main StreetF k _ - Departnt` is gn fure/ate 4` ,� W 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 DANCER ZONE LITERATURE: lies No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA—(For department use) Q Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 r 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 IS OTE: 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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 4 Building Permit Application 4 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 Doe:Building Permit Revised 2014 Enter construction cost for fee cal- North Andover Fee Calculation Construction Cost 209,000.00 m $ - $ 240.00 Plumbing Fee $ 30.00 Gas Fee 100 comm. $1 1001.00 Electrical Fee $ 30.00 Total fees collected $ 400.00 59 Berrington Place 1074-15 on 6/1 212 01 5 Remodel master bath F NORTH Town of � ._ . :..1�. . n over No. 4'e I� - *�soh .� ver, Mass, -A ',, COCHIC.9- k 1 0LAKIED rP�`� T '(5 U BOARD OF HEALTH i Food/Kitchen PER. T T LD Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .1.'.���................ Foundation has permission to erect .......................... buildings on .. ...... ..... .. .... �.►. . .... Rough AJ to be occupied as ...�� � .. ...... ...... .... . . ..... ...... . ... ...................................................... Chimney 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. Rouen Final PERMIT EXPIRES IN LMONTH§ ELECTRICAL INSPECTOR UNLESS CONSTRUeo .4t,000000 Rough Service ........ ...... ................................ 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 Dr T Wall 1 o Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. TOWN OF NORM ANDOVER OF-FICE OF • f�Q � ,"h . 600-000d&100t Buff ding 20,-S-aitt,-2 36 7.S Ht35� ,�3cY4R3iX➢F4�'.�'L� I2 &Dvf;r,Massadhusettg 01845 sR� , Gerald A.Bi-ova • Telephone(978}688-95 5 Inspeetozof$iiildings -Fay (978)688-9542 QUISE©WNER LICEME MUPTI'ON . - 33M)NG)?FWMT. TPLICAMN TdeaseprinE . DATE: yS OB LOCATfON: It �l Number SlxeetAddres Map/ ot :90AMOWNER A su- ame. Home one WorkWhone PRESENT MAUiNG.ADDRESS c� • �� —Viv Cods Tho eurrenk eltiemPifon for"-homeown_ers'was extenctad to?'npItide ownez�occn Tied c1��ei1iogs+o i�vo units or lass an Z fa alloy snub omec ruerSt4EiF¢ean?�d��j[P18�-fOr I7T�� 0L7oB5au posSESSallem15ea 1r Adedtdla�ihoowzor acts as supervisor}, 8fatoBuilding (Code Saabon x08.3.5.1) .DEFINITION OFDOMENMEIR , I'erson(s)WhO awns a parcel oflana On which helsheresides or intends to MOD,an Which there is,or is infended to be,aoneortwo�'amilystcuetares. _h.person.�Tzoconstracfsmoretriat.one7romein:atyza-year�ezlodsl�a7Zvo-tbe considered abomeowner, The vudersig aed".homaciwuce,asuams responsibifAY fo_z-comPliances wi.Flz the State Building Code anti Ofier Applicable codes,by-law;zules arldiegOations. The uEdersigned=lomeowztez"certEesthat belsheiwderstandstheTownofjg0 rth,Audoverl3uildingDe�arEment ,ntznznJumspeefionproceduzesandrecluiromentsandthatholshewildcoM lywUhealdpraceduresand zec,[aire�ents, . 1101EOWMMS SIGNA.T'i)EE APPROVAL OF BMDMG OFFICTAL Revised 7.2949 _ y ' )FDnu ozneowners sxempfion • <ri 30ARD OFAI'P.EAm 68s-9541 C011rsETi vAaoN 6s8-9530 DEALT1689-95 0 PT,A NNmtrti�Q�o;a, Commonwealth o Massachusetts The Comm .� F Department of Industrial Accidents 1 Congress Street,Suite 100 Foston,MA 02114-2017 =~ 9c www.mass.gov/dia ' Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TBE pFRvffTTING AUTHORITY. Please Print Le 'bl A ' licant information Name(Business/Organizationfindividual): GA,1 Address: S Nf /�r„�y✓Q/ /n/�'o r `l Phone 4: City/State/Zip: �.: Are you nn employer?Check the appropriate box: Type of project(required); em to ees(full and/or part-time).* 7. F1Nd*'d6nstrU6tion 1.Q I am a employer with P Y 2.Q I an a sole proprietor or partnership and have no employees working for me m 8.temolffio�l emodeling Y capacity.an ca aci .[No workers'comp.insurance required.] s9, 3.❑1 am a homeowner doing all work myself[No workers'comp.insurance required.] 10[]Building addition 19I am a homeowner and will be hiring contractors to conduct all work on my property. I will 11.[]Electrical xepaixs or additions ensure that all contractors either have workers'compensation insurance or are sole bin repairs or additions proprietors with no employe6s. 12.[ Plumbing p 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13r.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance-1 14.Q Other 6.Q We are a corporation and its.officers have exercised their right of exemption per MGL c. 152, loyees.[No workers'comp.insurance required] §1(4),and we have no emp *Arry applicant that checks box#i must also fill out the section below showing their workers'compensation policy information: I homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached 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. compensation insurance for my employees. Below is the policy and job site jam an employer that is providing workers' information. Insurance Company Name: Expiration Date:. policy#or Self-ins.Lic.#: City/State/zip- fob Site Address: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). nal Failure to secure coverage ntea required as civil ivier l penalties inthe form of a 25A is a STOP WORK.ORDER and a fine f up to$2550 00 a ation Punishable by a fnib Up to$1,500-00 and/or one-year imprisonment, day against the violator.A copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. X do hereby ce par and enalties of perjury that the information provided above is true and correct. _ Date: Si azure: phone#: official use only. Do not write in this area,to he completed by city or town official. Permit/License City or Town: # Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Phone#- Contact Person: 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 Hie, express or implied,oral or written." An employer is•defnied 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 ofthe 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 b6 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 a license or permit to operate a business or to construct buildings in the commonwealth for any applicantwho has not produced-acceptable evidence of compliance with the insurance coverage requlred." 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 Pleasb 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 carry 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 confirmation 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 permit 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 Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 Tel.#617-727-4900 ext.7406 or 1-877-AIASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia e � z Od 3 e _ C o n� s e � �111%Cal CINSIDE Se i` -7 c. vPro 11`f b `PCZ iLia Claims Processing -Arnica Scan Center Toll Free: 1-877-75-AMICA PO Box 9690 (1-877-752-6422) u Providence,RI 02940-9690 Fax: 1-866-934-5962 AUTO HOME LIFE April 10, 2015 Ms Michelle A Rotter Mr Bryan Bendig 59 Berrington PI North Andover, MA 01845-2152 File Number: 60002095405 Date of Loss: 03/17/2015 Deductible: $2,500.00 Dear Ms. Rotter and Mr. Bendig: ICA Independent Adjusters estimates that the repairs to your home will cost $24,256.03 on a replacement cost basis. While your policy provides coverage for full Replacement Cost Value(RCV) of the damage to your home, it also states that we will pay no more than the Actual Cash Value (ACV) of the damage until actual repair or replacement has been completed. Our payment of$18,902.11 reflects the ACV of your home's damages less your deductible. We have withheld $2,853.92 in depreciation. We will make an additional payment to you for the RCV of the repairs, up to the amount of withheld depreciation, once we receive documentation confirming the actual cost you incurred to have the repairs completed. We will not pay more than the actual repair cost. Please call me with any questions. Sincerely, Kylie J. Wojahn AIC, AINS Arnica Mutual Insurance Company 877-752-6422 x21765 KWOJAHN@AMICA.COM nnA'MAwry AN41V A PP"PF.RTV AND CASUALTY INSURANCE COMPANY Insurance Claims Adjusters.Inc. Inc. 11405 North Community House Road Suite 400 Charlotte,NC 28277 1-877-807-9669 Voice 1-877-807-9670 Fax Home: 860-561-9672 Insured: Bendig,Bryan Cell: 860-490-9963 property: 59 Berrington PlE-mail: madlaxbryan@gm ail.com North Andover,MA 01845-2152 Home: 59 Berrington pl North Andover,MA 01845-2152 Business: 877-752-6422 x 21765 Claim Rep.: Duane Smith E-mail: duane457@aol.com Business: 903-216-0089 Estimator: Duane Smith E-mail: duane457@aol.co1n Policy Number: 65042023CU Type of Loss:Freeze Claim Number: 60002095405 Price List: MAEM7X_APR15 Restoration/Service/Remadel Estimate: BENDIG BRYAN our ersonal property and/or the estimated cost of covered repairs to your an 's final review.Your Policy may contain provisions that This is the estimated amount of observed damages for y P applicable coverage limitations to you- exclude This estimate is subject to Arnica Mutual Insurance Comp y could limit or exclude the amount paid for certain items.Your adjuster will explain any apP is not a guarantee that coverage will be provided and is not intended to replace any of the terms and conditions in This estimate your policy. our chosen contractor to attempt to reach an agreed figure for the covered repairs and/or W e will work with you and Y If you or your contractor disagree with the extent or cost of repairs outlined in this stance.Please remember that replacement of your personal property. Y or if additional damage is discovered,please contactecany supplemental damage providefurther the damaged items are repaired or estimate, opportunity to inspect y PP you are required to provide us with an replaced. u contact Y to notify them of the loss and mend Your Mortgagee may be included as r endorsing checks.Please ln additional payee.We etmns know yo we an help in this regard. discuss their specific requirements fo If on have any questions abort this estimate or any of the information presented here,please contact ns so we can assist You- if v wr' Insurance Claims Adjusters.Inc. Inc. 11405 North Community House Road Suite 400 Charlotte,NC 28277 1-877-807-9669 Voice 1-877-807-9670 Fax CONTINUED-Master Bath DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 17. Final cleaning-constrnction- 151.69 SF 0.20 0.00 6.06 36.40 (0.00) 36.40 Residential 1639 233.20 1,399.20 98.92 1,300.28 Totals: Master Bath Closet 1 Height:9'6" 459.00 SF Walls 164.25 SF Ceiling 623.25 SF Walls&Ceiling 164.25 SF Floor 1 18.25 SY Flooring 48.83 LF Floor Perimeter 51.33 IF Ceil.Perimeter 21611 X 61811 Opens into Exterior Door Window 3'X 4' Opens into Exterior DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV 18. Content Manipulation charge-per 1.00 HR 34.78 0.00 6.96 41.74 (0.00) 41.74 hour 19. R&R Batt insulation-6"-R19-paper 32.00 SF 1.24 1.24 8.18 49.10 (1.35) 47. faced 20. R&R Thin coat plaster over 1/2" 32.00 SF 4.66 1.46 30.14 180.72 (1.59) 179.1 gypsum core blueboard 1.00 EA 11.73 0.04 2.34 14.11 (0.47) 13.64 21. Mask and cover light fixture 0.20 0.51 6.68 40.04 (5.58) 34.46 22. Mask the floor per square foot-plastic 164.25 SF and tape-4 mil 23. Scrape part of the ceiling&prep for 132.25 SF 0.52 0.08 13.78 82.63 (0.90) 81.73 paint 2 164.25 SF 0.49 0.72 16.24 97.44 (0.78) 96.66 4. Texture drywall-light hand texture 25. Paint the walls and ceiling-two coats 623.25 SF 0.75 7.40 94.96 569.80 (80.53) 489.27 3.36 30.66 183.93 (3.65) 180.28 26. R&R Baseboard-3 1/4" 48.83 LF 3.07 27. Paint baseboard,oversized-two coats 48.83 LF 1.25 0.46 12.30 73.80 (4.99) 68.81 28. Sand,stain,and finish wood floor 164.25 SF 3.97 9.65 132.36 794.08 (157.50) 636.58 29. Final cleaning-contraction- 164.25 SF 0.20 0.00 6.58 39.43 (0.00) 39.43 Residential 24.92 361.18 2,166.82 257.33 1,909.49 Totals: Closet 1 Total: SECOND LEVEL 4131 594.38 3,566.02 356.25 3,209.77 4/8/2015 Page:3 BENDIG BRYAN I Insurance Claims Adjusters.Inc. CA ,Inc. 11405 North Community House Road Suite 400 Charlotte,NC 28277 1-877-807-9669 Voice 1-877-807-9670 Fax Height:9'6" r Family Room 823.63 SF Ceiling M991.98 SF Walls 823.63 SF Floor R I 1815.61 SF Walls&Ceiling 117.40 LF Floor Perimeter r f a 91.51 SY Flooring 1 117.40 LF Ceil.Perimeter 1 -23,10- Y X 4' Opens into Exterior Window 39 411 X 4' Opens Into Exterior Window V X 4' Opens into Exterior Window 31 6"X 4' Opens into Exterior Window 17'X 4' Opens into KITCBEN DEq Window O&P RCV DEPREC. ACV QUANTITY UNIT PRICE TAX DESCRIPTION 41.74 (0.00) 41.74 Manipulation charge-per 1.00 HR 34.78 0.00 6.96 45. ContentManip � 9822 (2.70) 95.52 hour 124 2.48 16.38 46. R&R Batt msulatlon-6"-R19 paper 64.00 SF faced 4.66 2.92 60.22 361.38 (3.17) 358.21 Laster over 1/2" 64.00 SF 47. R&R Thin coat p 14.11 (0.47) 13.64 gypsum core blueboard 11.73 0.04 2.34 1.00 EA 200.76 (28.00) 172.76 48. Mask and cover light fixture 0.20 2.57 33.46 49. Mask the floor per square foot-plastic 823.63 SF 469.42 and tape-4 mil 759.63 SF 0.52 0.48 79.10 474.59 (5.17) 50. Scrape part of the ceiling&prep for 3.91 484.71 3.60 81.44 . 488.62 ( ) paint 823.63 SF 0.49 234.58 1,425.35 51. Texture drywall light nand texture 0 75 21.56 276.66 1,659.93 ( ) two coats 1,815.61 SF 4.4,81 (1.49) 43.32 52. Paint the walls and ceiling- 3.27 1.38 7.46 11.00 LF 2 78 16.63 (1.13) 15.50 53. R&R Casing-oversized-31/4" 125 0.10 10.98 oversized-two coats 11.00 LF 1 88 11.30 (0.32) 54. Paint casing- 3.00 LF 3.09 0.15 7.14 55, R&R Window sill 2.09 0.04 1.26 7.21 (0.43) 442.21 (8.78) 433.43 56. Seal&paint window sill 3.00 LF 3.07 8.07 73.72 8.78 165.46 117.40 LF 29 58 177.43 (11.97) 57. R&RBaseboard-31/4" 125 1.10 3192.14 58. Paint baseboard,oversized-two coats 117.40 LF 3.97 48.39 663.64 3,981.84 (789.70) 197.67 and finish wood floor 823.63 SF 32.94 197.67 (0.00) 59. Sand,Stam, 823.63 SF 0.20 0.00 60. Final cleaning-construction- Residential 92.88 1,369.82 8,218.81 1,091.83 7,126.98 Totals: Famlly Room 4/8/2015 Page:5 BENDIG BRYAN i I ; s Adjusters-Inc- Insurauce Claim vs, Community Souse Road Suite 400 A ,Inc• 11405 North Charlotte,NC 28217 A 1-877-807-9669 Voice 1-877-807-9670 Fax Heights q 5. J Garage 793.18 SF Ceiling -81-6'1'1 793.18 SF Floor 15''" 1216. s" -- 34 SF Walls 2009.52 SF Walls&Ceiling 88.65 LF Floor Perimeter a 88.13 SY Flooring 115.15 LF Ce",Perimeter 267" 105'8 I Opens into BASEMENT 1-26'9" 2'6"X 6'8" Opens into Exterior Door 8'X71 Opens into Exterior Door g'X 7' Opens into Exterior Door 8'X71 DEPREC- ACS' RCV Door QUANTITY UNM PRICE TAX 06.96 41.74 (0'00) 41.74 34.78 0.00 143.26 DESCRIPTION 1.00 HR 147.30 (4'04) t Manipulation charge-pet 3.T2 24.54 71. Conten 1.24 (4.77) 537.33 hour R19-Paper 96.00 SF 842.10 R Batt insulation-6 4.38 90.36 72. R& 4.66 (0.47) 13.64 faced 96.00 SF 14.11 166.37 coat plaster over 112" 0,04 2.34 (26.97) 73. R&R Th"' 11.73 32.22 193.34 gypsum core blueboatd 1.00 EA 2,48 430.81 and cover light fixture 0.20 (4.74) 74. Mask a foot-plastic 793.18 SF 72.58 435.55 75. Mask the floor per sonar 0.52 0'`4 466.80 and tape_4 m11 for 697.18 SF 470.57 (3.77) e art of the ceiling&Prep 3.47 78'44 (259.63) 1,577.57 16. Scrap P 0.49 306.20 1,837.20 190.36 paint lighthandtextnre 793.18SF 0,75 23.86 190.36 (0.00) 77. Texture drywall2,009.52 SF 0,00 31.72 t the walls and ceiling-two coats 0.20 78. Pain 793.18 SF 304.40 3,567.87 79. Final cleaning-construction 645.36 3,812.27 Residential 38.39 Totals: Garage Height. .121211 _ Basement 1934.42 SF Ceiling 267^�6" ]934.42 SF Floor 1-56'4" 9^- 2162.36 SF WallsCeiling4096.78 SF Walls& 175.17 LF FloorPerime�214.94 SY Flooringeter 180.83 LF Ceil.PerimOpens into Exterior 31211 , �� 11 X 6 8 Opens into GARAGE Door 2'6"X RCV 6'8" DEPREC• ACV Door QUANTITY UNIT PRIG TAX 0818 49.10 (1.35) 47.75 1.24 DESCRIPTION 32.00 SF Pag 80. R&R Batt insulation- 6^_R19-Pape1 1.24 41812015 faced BENDIG BRYAN I 11405 North Community Claims Adjusters.Inc. _ Insuran 'i Road Suite 400 A ,IiCommunityHouse Charlotte,NC 28277 1.877-807 9669 Voice 1-877-807-9670 Fax Summa'for Coverage A-DweWMg 19,953.27 260.08 20,213.35 Line Item Total 2,021.34 Material Sales Tax 2,021.34 Subtotal $24,256.03 General Contractor Overhead (2,853.92) General Contractor Profit $21,402.11 Replacement Cost Value 2,500.00) Less Depreciation Aral Cash Value $18,902.11 Less Deductible 2,853.92 Net Claim $21,756.03 Total Recoverable Depreciation Net Claim if Depreciation is Recovered Duane Smith 4/8/2015 Pas BENDIG BRYAN i i Insurance Claims Adjusters.Inc. Suite 400 Inc. 11405 North CommumtY House Road Charlotte,NC 28277 '$ 1-877-807-9669 Voice 1-877-807-9670 Fax Recap by Room Estimate:BENDIG BRYAN 1.20% 239.04 Area:Exterior 1.20% Front Elevation 239.04 Area Subtotal: Exterior 5.16% 1,149.61 1,780.72 8,92% Area:SECOND LEVEL Master Bath 14.69% Closet 1 2,930.33 LEVEL 537.37 2.69% Area Subtotal: SECOND 768.81 3.85% i 6,756.11 33.86%27.53% Area:Main Level 5,493.41 Bathroom i Family Room 67.94% IUWhen/Dming Room 13,555.70 Area Subtotal: Main bevel 15.98% 3,188.52 0.20% 39.68 Area:BASEMENT Garage 16.18% Basement 3,228.20 MEQ 100.00% Area Subtotal: BASE 19,953.27 Subtotal of Areas 19,953.27 100.00% Total 4/8/2015 Page BENDIG BRYAN B[3SEMEN'r G N � M Garage N N 55-8 M M Basement 56 4° BASEMENT page:13 4/812015 BENDIG BRYAN SECOND LEVEL 15' 14, 4„ M 1311011 --- 131611 Master Bath "cn � � - o Closet 1 14' 8" G� 141211 SECOND LEVEL 4/9/2015 Page:15 BENDIG BRYAN > Restorepro 21 A Sixth Road Woburn""01801 Phone 800-847-0114 Home: 860-561-9672 Insured: Bendig,Bryan Cell: 860-490-9963 property: 59 Berrington PI E-mail: madlaxbryan@gmail.com North Andover,MA 01845-2152 Home: 59 Berrington PI North Andover,MA 01845-2152 Business: 877-752-6422 x 21765 Claim Rep" Ste 500 Wojahn,Kylie J. E-mail: KWOJAHN@AMICA.COM Business: 12410 East Mirabeau Parkway Spokane Valley,WA 99216 Business: 781-438-0096 Estimator: Dan H. Position: Project Manager Company: Restorepro Inc. Policy Number: 65042023CU Type of Loss: Freeze Claim Number: 60002095405 Date Contacted: 3/31/2015 1:22 PM Date Received: 3/3112015 10:10 AM Date of Loss: 3/1712015 10:09 AM Date Entered: 4/2012015 3:30 PM Date Inspected: Price List: MAEM8X APR15 Restoration/Service/Remodel Estimate: BENDIG_BRYAN VS Restorepro 21 A Sixth Road Woburn,NIA 01801 Phone 800-847-0114 BENDIG BRYAN BENDIG BRYAN QTY UNIT PRICE TOTAL DESCRIPTION 442.94= 531.53 1.20 EA @ 40.40 65. Single axle dump truck-per load-including dump fees 4.00 EA @ 10.43= equipment(hazardous cleanup) 47.43= 189.72 66. Add for personal protective equip 4.00 HR @ 67. Equipment setup,take down,and monitoring(hourly charge) Main Level Main Level QTy UNIT PRICE TOTAL DESCRIPTION77.50= 232.50 68. Negative air fan/Air scrubber(24 hr period)- No monit. 3.00 DA @ Height:8' 11" Kitchen 3' 11"X 4' Opens into Exterior Window 2'6"X 6'8" Opens into Exterior Door 2'61'X 61811 Opens into Exterior Door 2'6"X 6' 8" Opens into Exterior Door 21611 X 6' 8" Opens into Exterior Door 13' 111 X 618" Opens into GREAT ROOM Missing Wall-Goes to Floor 51 8" X 6'8" Opens into Exterior Door 2, 1„ X61811 Opens into Exterior Missing Wall-Goes to Floor 51211 X 31411 Opens into Exterior Window 51211 X 314" Opens into Exterior Window 3'3"X 3' 3" Opens into Exterior Window 3'211 X 618" Opens into Exterior Missing Wall-Goes to Floor QTY UNIT PRICE TOTAL DESCRIPTION80.00 SF @ 0.65-- 52.00 13.20 1. Containment BarrierlAirlOck/Decon.Chamber 4.00 DA @ 3.30= per day 0.38= 53.20 3. Containment Barrier-tension post-p 140.00 SF @ 76.14 4. Protect-Cover with plastic 84.60 SF @ 0.90= wall,cleanup,bag for disposal 0.68- 10.88 6. Tear out wet dry 16.00 SF @76.56 7. Tear out and bag wet insulation 174.00 SF @ 0 A4= PER SF) 0.23= 19.46 8. HEPA Vacuuming-Light-( 84.60 SF @ 9. Apply plant-based anti-microbial agent Height: 11'S" Great Room 5!812015 Page: BENDIG_BRYAN i Restorepro �trnlwtltl MA 01801 2]A Sixth Road Woburn, Phone 800-847-0114 Opens into Exterior 21711 X 5' Opens into Exterior Window 5'X 616" Opens into Exterior Window 2'7"X 5' Opens into Exterior Window 2'7"X 5' opens into Exterior W 2 -Window '21711 X 5' Opens into Exterior Window 2,711 X 5' Opens into Exterior Window 21711 X 5' Opens into Exterior Window 8'X 11, 511 opens into Exterior Missing Wall-Goes to Floor 21711 X 5' peens into KITCHE Window 13' 1"X 6'8 Opens into Exterior Missing Wall-Goes to Floor 3, 10" X 11' 5" TOTAL QTY UNIT PRICE Wall 48.90 Missing 48.90= 1.00 EA @ 0.65= 247.00 DESCRIPTION 380.00 SF @ 23.10 3.30= 89.25 13. Contents-move out then reset 7,00 DA @ 0,38= 15. Containment BarrierlAirlock/D o t-P r dayeC 234.97 SF @ 0.90= 446.55 16. Containment Barrier-tension p 496.17 SF @ 0.69= 286.68 17. Protect-Cover with plastic ba for disposal 421.59 SF @ 0.44= 240.31 19. Tear out wet drywall,cleanup, g114.12 546.17 SF @ 0.23= 20. Tear out and bag wet insulation 496.17 SF @ 14.73 Light-(PER S� 0.38= 21. NEPA Vacuumin0- g gent 38.75 LF @ 17.44 0.38= 2.32 22 Apply plant-based anti-microbia ab 45.90 LF @ 0.29= 70. Tear out baseboard 8.00 LF @ 71. Tear out trim 72. Ducting-lay-flat Basement T PRICE TOTAL QTY UNI 155.0C Basement 77.50= 2.00 DA @ DESCRIPTION period)-No monit. 63. Negative air fanlAir scrubber(24 hr p height: Opens into Exterior Garage 2'6"X 6 8 opens into Exterior Door 3'2"X 6'8" Opens into Exterior Door 9'4"X 7' Opens into Exterior Door 9' 4"X 7' opens into Exterior Door 9' 4"X 7' Opens into STAIRW 5 g12015 Door 3'8"X9' Missing Wall-Goes to Floor BENDIG BRYAN i v�Q Restorepro 21 A Sixth Road Woburn,MA 01801 Phone 800-847-0114 QTY UNIT PRICE TOTAL DESCRIPTION36.71= 36.71. 1.00 EA @ $8.50 25. Contents-move out then reset-Small room 90.00 SF @ 0.65= 22.80 26, Containment Barrier/Airlock/Decon.Chamber 60.00 SF @ 0.38- 54.45 for disposal 068= 41.14 28. Protect-Cover with plastic 60.50 SF @ 0.90= 29. Tear out wet drywall,cleanup,bag p 60.50 SF @ 39.82 30. Tear out and bag wet insulation 90.50 SF @ 0.44 31. HEPA Vacuuming-Light-(PER SF) 25.00 SF @ 0.23= 5.75 32. Apply plant-based anti-microbial agent Level 2 Level 2 QTY UNIT PRICE TOTAL DESCRIPTION77.50= 155.00 64. Negative air fan/Air scrubber(24 hr period)-No monit. 2.00 DA @ Height:10' Master Bath 21611 X 61811 Opens into Exterior Door 21711 X 5' Opens into Exterior Window 6' 1"X41 Opens into Exterior Window 216" X 61811 Opens into SHOWER Door QTY UNIT PRICE TOTAL DESCRIPTION 36.71= 36.71 LOU EA @ 32.50 34. Contents-move out then reset-Small room 50.00 SF @ 0.65= 6.60 35. Containment Barrier/Airlock/Decon.eh 30 = chamber 2.00 DA @ 3. 36. Containment Barrier-tension post-p day 70.00 SF @ 0.38= 26.60 90= 69.30 37. Protect-Cover with plastic 77.00 SF @ 0. 2040 38. Tear out wet drywall,cleanup,bag for disposal 30.00 SF @ 0.68= wet insulation 0.44= 41.80 39. Tear out and bag 95.00 SF @ 17.71 40. HEPA Vacuuming-Light-(PER SF) 77.00 SF @ 0.23= 41. Apply plant-based anti-microbial agent 5.50 LF @ 0.38= 2.09 42. Tear out baseboard Height:8'3" Master Closet 2'7" X 5' Opens into Exterior Window 1' 11"X 61811 Opens into Exterior Door 5/8/2015 Page: BENDIG_BRYAN 5/8/2015 Page:5 BENDIG_BRYAN Phone 800-847-0114 DESCRIPTION QTY UNIT PRICE TOTAL 1.00 EA @ 48.90= 48.90 44. Contents-move out then reset 45.00 SF @ 0.65= 29.25 45. Containment Barrier/Airlock/Decon.Chamber 2.00 DA @ 3.30= 6.60 46. Containment Barrier-tension post-per day 133.44 SF @ 0.38= 50.71 47. Protect-Cover with plastic 13.30 LF @ 4.20= 55.86 48. Tear out wet drywall,cleanup,bag,per LF-up to 4'tall 36.72 54.00 SF @ 0.68= 50. Tear out and bag wet insulation 110.00 SF @ 0.44= 48.40 51. HEPA Vacuuming-Light-(PER SF) 54.00 SF @ 0.23= 12.42 52. Apply plant-based anti-microbial agent 8.00 LF @ 0.29= 2.32 73. Ducting-lay-flat Height:8' 3" Guest Bedroom 21611 X 6'8" Opens into BATHROOM-2ND Door 51 111 X 61 811 Opens into Exterior Door 2'6" X6' 8" Opens into Exterior Door Opens into Exterior Window 51511 X 5' QTY UNIT PRICE TOTAL DESCRIPTION 16.00 SF @ 0.23 3.68 61. Apply plant-based anti-microbial agent = Grand Total Areas: 10,5 5,18378 SF Ceiling 10.77 SF Walls and Ceiling . 5,326.99 SF Walls 574.87 LF Floor Perimeter 5,183.94 SF Floor 575.99 SY Flooring 0,00 SF Long Wall 0.00 SF Short Wall 695.46 LF Ceil.Perimeter 5,183.94 Floor Area 4,763.62 Total Area 5,507.28 Interior Wall Area 5,070.52 Exterior Wall Area 729.64 Exterior Perimeter of Walls 0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 Total Hip Length Q>�Q Restorepro 21 A Sixth Road Woburn,MA 01801 Phone 800-847-0114 Summary for Coverage A-Dwelling 3,943.73 Line Item Total 27.16 Material Sales Tax $3,970.89 Replacement Cost Value (2,500.00) Less Deductible $1,470.89 Net Claim Dan H. Project Manager 5/8/2015 Page:6 BENDIG_BRYAN a�®f1 Restorepro sement (V 3'3"� I 1 1 Garage d N Basement T M Flo 0 l � 3'1011- 3'10"- -3, '10"--3'10" -3'6" r, �1•� LI:L 19'2" 64'11" lJ�1 Basement BENDIG_BRYAN 5/8/2015 Page: tin Level 32' NEIN 37'3" 1 —373" i in I� `D lio ilfl Kitchen I 2'7 o Great Room m m il+ 1 V) 3-10"'—a —3-6" 00 g,6" i L= 1915.1 20'1" IJV Main Level BENDIG_BRYAN 5/8/2015 Page:E vel 2 52' 1" 3'6" 61711 _ 4' 131411 715111 _ 14' 11" ch tV CD 1 1 _ Master Closet ~2 N �O Master Bath �O - 2' o room 2nd - _ 6'8" ic _ M h — - Guest Bedroom 61411 M M T �o M ShowerOO 1 15' 1" `O E--5'7"— 6'8" 1 7'4"- -' � 151711 Lam? LJ Level BENDIG_BRYAN 5/8/2015 Pag