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HomeMy WebLinkAboutBuilding Permit #459-15 - 73 BRADSTREET ROAD 11/12/2014BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION i Permit No#: 15 —1 � Date Received Date Issued: I C -6A D� t•tLEO 16=•ry°\ ° ' IMPORTANT: Applicant must complete all items on this page PROPOSED USE Residential Non- Residential ❑ New Building "_I;�'frz: ,4,PRORERITJYt011VNER ❑ Addition . Pnnt°.� tee,; e100 Year Structure =yes rno C - - •� `MAP , _P,�ARC;EL ZONING DIS�TRPCT� Historic ®istnct- es' .. inPaSnn/x a:llanPa.vac n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building —60ne family ❑ Addition ❑ Two or more family . ❑ Industrial Alteration No. of units: ❑ Commercial 16Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Y'e.a" ,OSeptic, ;®Well{��❑ Y,. Flo dlain', „OWetlantls� #�❑WatershedDstnct �'i,yr.,. fF �' T" a—e. .1.-.r'L �`p • a r k .� 'g � � i. ; - f=L •. q €-' S- Y,`v `�-a _ ft 4'ei ^9 .F�•9" 't ."Water/Sewer _ - it, _=J+�e'.. a..... �� _ +�' . 3�-. _ 'E3r'.+.e� �2 �2 �, '�h. x..-r.sw � .�'.-.#-`-� �+`w �'� DESCRIPTION OF WORK TO BE PERFORMED: Y,.k/t—ty S I U 1, Identification - Please Type or Print Clearly OWNER: Name: �tt��� ?\�,,�,,� Phone:4n<�- 02Z,-2L(�� ARCHITECT/ENGINEER Phon 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: $ 271 L'I'J U FEE: $ 332— Check 32— Check No.: )'74,510 Receipt No.: 2 NOTE: Persons contracting with unregistered contractors do not have access to the-uaranty fund 9 0 Sr --1 0 m m 0 0 5rOE-.CD CD 2 0 z 0 CD CD 00 n CD C -0 z CD 0 CD -n -CD 10 CD CD o. � � V> Gq Plans Submitted ❑ Plans Waive Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swumning 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 Siqnature 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 Tawn F.TQ1nPPr• Cianat�ira• 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 — (1 -or department use ❑ Notified for pickup Call Email 3 Date Time Contact Name Doc.Building Pen -nit 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 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 ❑ 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) 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 o 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 C V� C7 0 CDCD 0 CL e� �' N .a 0 vCD cD o CL Cr rs. (D CD 0 03 CDW CL CD v cn CC C � v 0 0 o O N 0 CD in - D :- O O Z -h cD N co O cm X CD CQ C 0. U) U) 0 0 0) z Cl)Cr U) M. �cD�� 0 0 rt CL C9 ON a CD O O .+ Q, 0 T W 0 U) p Cl) CD 2 Q 2) -% C —I U), O 0) 0 CD CD CD'a v O < to3w N.rt O O N 0 = N ' CD O 0 O• =0� 0 � �' = r. CD CD0 5 �CD CD `D CL CD Ndow IDlb' O cm CD CD CDO CD I yC s S O �j ' O� CL :e . H 0 O (0 � ° `� 1—O, (D O Z coNIEL C 3 '—� o M D �. m z T 2L .Z7 O cd S N z �' m O T 7 N � n (D .Z1 O S m m '° a r H m T S. SCJ O UCC S M r C W z G1 N m r) T � _S 7 N ,G O 000 S O 7 Q N Y b W C v G N m (D n N < 3 O Q \ n ' W v O yT1 = N C: W) (© e «— { , ®{6a»\\ &$ �f > / 0 C c •\ Q » «, Oil w ¥y « . = Z q® 7 U79/ w yy< / �./}�9 `2 fNle 0 °a22«� m 5 .2 {/\}�$$ k .k ; CO A u _— §.2 ; W o �k\ / o ° ' k \ e o 0) \ E _ & \w0 }\�� m§ / \ ƒ 2 2 IN ' \ \ / U- 00 f / § 2 $ y N F] K,'ev% , MV ur p h Building Contractor Proposal To: Patricia Glynn 73 Bradstreet Road North Andover, Ma 01845 From: Kevin Murphy CC: Date: 11/12/2014 Job: Windows / Kitchen Date of plans: None Architect: None Location: Same Section 1- Work Schedule • 98 Forest Street • North Andover, MA 01845 • PH: 978-688-5335 • FAX: 978-688-7207 All Home improvement Contractors and Subcontractors engaged in home improvement oonhact ing, 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 10/20/14. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 11/30/14. 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 111- Scope of Work Page 1 of 4 Kevin Murphy Building Contractor 98 Forest Street North Andover, MA 01845 PH: 9788&5335 FAX 978688-7207 General Page 2 of 4 Proposal is to replace windows in existing porch, and renovate kitchen. Building permit will be obtained by contractor. Building New Harvey windows will be supplied and installed in porch, kitchen, and garage. Three triple casements, one single casement, and two small stationary window sashes will be replaced in porch. One twin casement will be replaced in kitchen. Two doublehung windows will be replaced in garage. Porch and kitchen windows will be vinyl exterior, and clear pine interior. Garage windows will be all vinyl. Any miscellaneous materials required to install windows, will be provided. Plumbing New kitchen sink and faucet will be suppllied and installed. An allowance of $1200 has been included for sink and faucet. Electrical Electrical work required to add new circuit for microwave above stove, will be provided. Interior Trim/Doors New kitchen cabinet will be supplied and installed above existing stove. An allowance of $500 has been included for cabinet. Flooring New tile floors will be supplied and installed in porch and kitchen. Tile backsplash will be supplied and installed in kitchen. An allowance of $6 per square foot has been included for tile materials. Other Allowances An allowance of $4000 has been included to supply and install new granite countertops in kitchen. Waste Removal All demolition / construction debris will be disposed of by contractor. Items Not Included No allowance has been made for any painting, replacement of kitchen cabinets. Kevin Murphy Building Contractor 98 Forest Street North Andover, MA 01845 PH: 97868&5335 FAX 978-68&7207 Section IV - Price Schedule Total We hereby propose to furnish material and labor — complete in Accordance with above specifications for the sum of ..................................... $27,700 Payment to be made as follows: PercentageAtem Description Amount 1 Deposit / Permit obtained $2700 2 Windows installed $10,000 3 Counters / floors installed $10,000 4 Job 100% Complete $5000 4 $27,700.00 "'Notice: No agreement for Home improvement contracting work shall requin: 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 andlor 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 Signaturec`-i�" g.J" Date 111 11 1 1 W Signature Date AGORI CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD'YYYY) 16/25/2014 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 M P ROBERTS INS AGCY INC 1060 Osgood Street North Andover, MA 01845 NOMTACT Sandi Munroe PHONE 978 683-8073 FAX N :(978) 683-3147 E-MAI E�:san 1 mpro ertslnsurance.com INSURERS AFFORDING COVERAGE NAIC# I SURERA� MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING 169 BOXFORD STREET NORTH ANDOVER, MA 01845 INsuRERB: GUARD INSURANCE INSURER INSURER D: INSURER INSURER F COVERAGES CFRTIFICATF NIIMRFR• RF\nRlnNl NIINARFR• 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. NSR LTR TYPE OF INSURANCE UL IN bUbK D ICY MBER POLICY EFF POLICY MM DQ1Y EXP LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 0 OCCUR EACH OCCURRENCE $ 11000,000 MSE E $ -900,000 NED EXP oneperson) $ 15,000 A BOPI068945 11/22/1311/22/14 PERSONAL&ADV INJURY $ INCLUDED n'0THER' LAGGREGATE LIMIT APPLIES PER POLICY [:]JECT ❑LOC GENERAL AGGREGATE $ 2r000r000 PRODUCTS-COMP/OP AGG $ 2 000 000 $ AUTOMOBILE LIABILITY COMBINEDSNGLEUMT $ IF,aCC ( I l BODILYINJURY (Perperson) $ BODILY INJURY (Per accident) $ A ANYAUTO ALLOWNED }( SCHEDULED AUTOS MCA7O13608 01/23/14 1/23/15 HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ =' UMBRELLA LIAB OCCUR. EACH OCCURRENCE $ 1,000,000 A EXCESS UAB CLAIMS -MADE CUP9145304 11/22/1311/22/14 AGGREGATE $ � � 000 E R ENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X PER OTH- T ER E.L. EACH ACCIDENr $ 500,000 B ANY PROPRIETORMARTNERIEXECUI-IVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) Ifyes, descrbeunder ES I I F RATI I N/A KEWC527844 07/01/14 7/01/15 E.L. DISEASE - EA EMPLOYEE $ 500,000 500 000 E.L. DI S- LI YLIMIT i I iiE I I DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHOCLES(ACORD 10 1, Addibonal Remarks Schedule, maybe attached if more space is required) CFRTIFI(:ATF H(TI nFR rnnrrCI r ATlnnr TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1600 OSGOOD STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NORTH ANDOVER MA 01845 ACCORDANCE WITH THE POLICY PROV ISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations IN 600 Washington Street Boston, MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lelribly Name (Business/Organization/Individual): i kv i Address: Sb Ge.n6 F- City/State/Zip: �� , p._ a).c, M�. u x�" Phone #: 52 �_ -(611 -5 31 Are you an employer? Check the appropriate box: 1.16 I am a employer with _� 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. I ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. [:1 We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. C. 152, §1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other *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 a're doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:_ w✓>�.�� $i Ci Policy # or Self -ins. Lie. #: kC C UC_ 5 In 0 Lt 'J Expiration Date: Job Site Address: 'i 3 l�nsei.S�—�vie�► City/State/Zip: tiy , Q �. v�\`� Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL o. 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 herebyrcertify under the pains and penalties ofperjury that the information provided above is true and correct. -N ­�- - bCV Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # L 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