HomeMy WebLinkAboutBuilding Permit #496-2016 - 70 GREEN HILL AVENUE 10/20/2015Permit No#: qlI '- v Y
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BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
D&One family
❑ Addition
❑ Two or more family
❑ Industrial
t Alteration
No. of units:
❑ Commercial
❑ Repair, replacement
❑ Assessory Bldg
❑ Others:
❑ Demolition
❑ Other
*Septic ❑ 1Nell
❑ Floodplain ❑ Wetlands, 'r
❑ Watershed�Qistnct
Water/Sewer
,..
.p.s
.�,
DESCRIPTION OF WORK TO BE PERFORMED:
S �•.s �.\\ .� �'y�� l� t� b,..�.�.�"' �tay.�r,� �� �.. a �. �. �.� is �e� ! �. �Z.►�� L'..�,/�r
Identification - Please Type or Print Clearly '
OWNER: Name:, t_ R. -y kc- Phone: `laoq, . 07,1—
A
Address: `10 b 6L4 ix J�-
i< m
ContractortNarne Phone j
Address
SO ennsor s Construction
;Homelmprovement License .�o��� ��z'i Exp®ate Y _ - �b �.
ARCHITECT/ENGINEER C�.&2stA 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: $ `, !:k ►630 FEE: $ 35V _,cc,
Check No.: \-�)&3 ) Receipt No.: �I
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
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
o 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
o Building Permit Application
o 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)
o Mass check Energy Compliance Report (If Applicable)
o 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)
o 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
V,
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
PLANNING & DEVELOPMENT Reviewed On
COMMENTS
Signature
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 Town Engineer: Signature:
1rIKCkL)tr—AK1 ivicry T tKefll
Locate&at 124Main Stre.
Fire,Departmen ,signature,
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
I ❑ Notified for pickup Call Email
Date Time Contact Name
Doc.Building Permit Revised 2014
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*1 M-ur"Phy 98 Forest Street
• North Andover, MA 01845
• PH: 978-688-5335
Building Contractor FAX: 978-688-7207
Proposal
To: Paul & Mary Alice Rock
70 Greenhill Road
North Andover, Ma. 01845
From: Kevin Murphy
CC:
Date: 9/29/2015
Job: Kitchen / windows
Date of plans: None
Architect: None
Location: Same
Section I - Work Schedule
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 10/10/15.
Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 11/25/15. 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
Building Contractor
98 Forest Street
North Andover, MA 01845
PH: 9788885335
FAX: 978888-7207
General
Page 2 of 4
Proposal is to partially renovate existing kitchen, and replace five window units. Permit will be obtained by
contractor.
Demolition
Existing kitchen wall will be removed. Ceiling in family room will be removed. No allowance has been made to
completely gut kitchen or family room.
Building
,w All materials required to remove wall, and replace windows will be provided. Five Harvey all vinyl replacement
windows will be supplied / installed in existing openings. Minor exterior rot at front entry will be repaired.
Plumbing
Plumbing required to replace kitchen sink / faucet will be provided. Sink / faucet to be supplied by owner.
Electrical
Electrical work required to remove wall, add lights in family room / kitchen, and upgrade service to 200 amps will
be provided. Any surface mounted fixtures ( pendants ) to be supplied by owner, installed by contractor.
Heating/Air Conditioning
No allowance has been made for any heating or air conditioning.
Insulation
Existing insulation to remain.
Plaster
Plastering / patching required for removing wall and replacing family room ceiling will be provided.
Interior Trim/Doors
Interior trim will be supplied / installed to match existing. New island in kitchen will be installed. Existing
cabinets will be relocated as required. Island cabinets / countertops to be supplied by owner.
Painting
Interior painting for kitchen and family room will be provided. Kitchen cabinets will be painted. One coat of
primer, and two coats of finish will be applied.
Flooring
No allowance has been made for any flooring.
Kevin Murphy
Building Contractor
98 Forest Street
North Andover, MA 01845
PH: 978-688-5335
FAX 978688-7207
Waste Removal
All demolition / construction debris will be disposed of by contractor.
Page 3 of 4
Kevin Murphy
Building Contractor
98 Forest Street
North•Andover, MA 01845
PH: 97888&5335
FAX: 97888&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 ..................................... $29,850
Payment to be made as follows:
Percenta alItem
Description
Amount
1
Permit obtained / deposit
$2850
2
Demolition complete
$5000
3
Windows ionstalled
$10,000
4
Cabinets installed
$8000
5
Job complete
$4000
5
$29,850.00_
"Notice: No agreement for Home improvement contracting 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 CONT CT IF THERE ARE ANY BLANK SPACES
Signature Date c�
Signature RAIT Date C S
The Commonwealth of Massachusetts
Department of IndustrialAccidents
I Congress Street, Suite .100
Boston, MA 02114-2017
-�" www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERM1 1TTING AUTHORITY.
Applicant Information Please Print Leaibiv
Name (BusinessfOrganization/Individual):
Address: s �'ro.+.a. "
City/State/Zip: th ty. . 0\V-tVhone #:.
Are you an employer? Check the appropriate box:
1.I am a empioyerwith_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.Q 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.FJ 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?
6.Q 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.)
1
Type of project (required):
7. ❑ New construction
8_-P14V Remodeling
9. Demolition
10E] Building addition
11.❑ Electrical repairs or additions
12.0 Plumbing repairs or additions
13. ❑ Roof repairs
14. [] Other
}Any applicant that checks box 01 must also fill out the section below showing their workers' compensation policy information.
r 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 ani an eiriployer iliat is providing iporlrers' compensation irisurarice for my employees. Below is the policy and job site
information. �+ p
Insurance Company Name: C s , o Jk 1+,J1
Policy # or Self -ins. Lic. #: Expiration Date: " . t X ( 00
Job Site Address: *. �,,,,�
���- � � City/State/Zip:
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.
Ido hergby certify under thepains andpenalties ofperjury that the information provided above is true and correct
Official use only. Do not write in this area, to be completed by city or tmvn offtciat
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
CnVFRAn FS r^.FRTIFIrATF MIJMRFR• RFVICIAN NIIMRFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE LOW 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
OF LIABILITY INSURANCE
FDATEMCERTIFICATE
5/2015
THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATIONONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATWELYOR NEGAT[MY 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
REPRESENTATIMR PRODUCER, AND THE CERTIFICATEHOLDER.
IMPORTANT: N the cer0cateholder is an ADDITIONALINSURED,the poliey(les)nust be endorsed. N SUBROGATIONIS WAIVED,sub)ectto
the termsandeonditionsofthe policypertainpolkhmayrequimnendorsemonLA statemerdon thlscarifieatedoesnot eonferrightstothe
eeRNicatsholder In lieu of such endomernard(s).
PRODUCER
; �,E"GT Sandi Munroe
M P ROBERTS INS AGCY INC
1060,Osgood Street
North Andover, MA 01845
(ZNE FAx
A/C, No,Frt: 978)683-8073 (978)683-3147
EMAIL sandi@mprobertsinsurance.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC4
INSURERA: MERCHANTS INSURANCE
INSURED KEVIN MURPHY BUILDING & REMODELING
INSURER B: GUARD INSURANCE
169 BOXFORD STREET
INSURERC:
INSURERD:
NORTH ANDOVER, MA 01845
INSURER E
INSURERF:
CnVFRAn FS r^.FRTIFIrATF MIJMRFR• RFVICIAN NIIMRFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE LOW 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,
EXCLUSION.SANDCONDITIONS OF SUCH POLICIES, LIMITS SHOWNMAY HAVEBEEN REDUCED BYPAID CLAIMS
uaw
cm
TYPE OFINSURANCE
NORTH ANDOVER MA 01845
POLICY NUMBER
POLICY EFF
POLICY EXP
-
LIMITS
X COMMERC14LWHEM LJABIUTr
EACH OCCURRENCE $ 1 000,000
PREMISES occu— $ 500,000
CLAIMS -MADE D OCCUR
MEDEXP(AnY—Person) $ 15 000
A
BOPI068945
-
1/22/14
1/22/15
PERSONAL& ADV INJURY $ INCLUDED
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 2,000,000
X — LOC
POLICY JECT
PRODUCTS-cOMP/OPAGG S 2,000,000
It
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT S 1,000,000
Ea accident)
BODILYINJURY(Perperson) $
A
ANYAUTO
ALL OWNED SCHEDULED
X
AUTOS AUTOS
MCA7013608
1/23/15
01/23/16
BODILY INJURY (Per eccMeM) $
PROPERTY DAMAGE $
er eocideni
NON -OWNED
HIRED AUTOS AUTOS
5
UMBRELLA LIAR
OCCUR
EACH OCCURRBL(E q 1,000,000
A
EXCESS LIAR
Fla.NMS-MADE
CUP9145304
1/22/14
1/22/15
AGGREGATE s 1,000,000
DED I I RETENTION $
S
B
WORKERS COMPENSATION
ANDEMPLOYERVUABILIN
Y'"00
movw�T°wvwan�wnva �
""F"'� N) °a�°' N
(MandaMrltn NN)
N IA
KEWC633734
7/01/15
7/01/16
X PER OTH• -
STATUTE ER
E.L. EACH ACCIDENT S 1 000
EL DISEASE -EA EMPLOYEE 13 500,000
If yes. under500
DESCRIPTION OFOPERATIONS belaw
E.L. DISEASE -POLICY LIMIT S / 000
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, AddWanal Remaft S hadWe, may be attached if mde apace Is requhd)
CERTIFICATE HOLDER CANCELLATION
TOWN OF NORTH ANDOVER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE Gwca.LED BEFORE
.
INE EXPIRATION DATE THEREOF. NOTICE. WILL 13E DELIVERED IN
_
ACCORDANCE WITH THE POLICY PROVISIONS
NORTH ANDOVER MA 01845
AUTHORIZED REPRESENTATIVE
01988-2014ACORD CORPORATION: All rights reserved.'
ACORD25 (2014/01) The ACORD name and logo are registered marks of ACORD
�j
c mer'ATfariam°oaur .cr�ead"0'
Office of Co`nsGirs & aBusi
ss Regulation
OME IMPROVEMENT CONTRACTOR
ulvo
egistration: w101874 xpiration:,-::=6/29%20,16, Type. �- -; Individual I
KEVIN MURPHY t`.. = =
Kevin Murphy C 1
98 FOREST ST.
N. ANDOVER, MA 01845 ' ^ g��G
Undersecretary
t of Public Safety
De artrn d Standards
�" ,chusetts D P ulations an
goarto
d.of Suilciing Reg
e: CS -053099
Licens rvisor
Construction Supe
KEVIN W M
URPHY`
;t 98 FOO
REST VER N1A 018'1
NORTH
r
Expiration: ,
0612912017
�i ` Commissioner _ ---