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HomeMy WebLinkAboutBuilding Permit #628 - 85 SOUTH BRADFORD STREET 3/22/2011TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 6.209 - Issued: 3AL Z/i Of IMPORTANT: Date Received must complete all items on this LOCATION cs c cA 68,c g u"C �r , pv� Ot ry.- Print_ PROPERTY OWNER C,y vvA Io . J a `r C. P Print MAP NON -3- 0 PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE O ty o'C– `W,4 Phone: f? 6 88 aa4 Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg 0 Others: X -Demolition ❑ Other {p eptic' ®Well � eater/Sewer _ !. oodplairr_ I�'Wetlarids`T WatershedtDistnct 7. DESCRIPTION OF WORK TO fv� Vvl C-1 Identification Please OWNER: Name: J o V uk! r_.n Jvtn t✓ s U ta trt -l- ipe or Print Clearly) Phone:y?$ Q33 -1S00 CONTRACTOR Name: SedV O ty o'C– `W,4 Phone: f? 6 88 aa4 Address: � (s c�X 3 a"g �wy`e-�-C.0 NjAA D lR L+ Supervisor's Construction License: CS -L7 6ok0 Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: s Address: Reg. No. FEE SCHEDULE: BULDING PERMIT. $12.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. ' Total Project Cost: $ W�7�-i • 3 FEE: $ 30'— Check 0'—Check No.: :T!41, 2!r Receipt No.: .23�? 7 NOTE Persons contracting with unregistered contractors do not have access to the g ranfun 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 Y .COMMENTS r HEALTH Reviewed on Signature COMMENTS A 1 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: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date 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 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 MOTE: 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: Doe.Building Permit Revised 2008mi W W tv O u o a U GG °41 Cd c t wo' CU" U w U R+ ' Cno ao' w o. W a m 2 U) w O v w W W w - v Gq o z cin v Q . a cn E y L w N zip. �H c m CD C CID 0 cm c �C N CD t_ O Z O g O F. : C S O L _O C O p O � O Om C p O v � O V m m �d0 : < R t Cc c C Q O o env a cma C o N�mr a O � co C CF C..2 co m C ' •s v `oa N E5 c o: " m z C3 S u cm CL= mm Cl R -I' N N cf m� C 7 . c a _m qw= C �J N :Em c a� y m � 'O cm C vCm.1 y O c3mZ m NID C _ m E m p y.C,,, :a COD W C cawsl-- •d H N t C `m -4D co v O m. C V� dca Z '= H c L y CL E y L w N zip. �H c m CD C CID 0 cm c �C N CD t_ O Z O g O F. LLI 0 W W luW N O L _O Z O p H c O Om 0 p O y m m 3� Q O o env a cma C o � c cv cc d O � co C zV C..2 co O C C c CL COD LLI 0 W W luW N SERVPRO° " Customer Name: Authorization to. Perform Services and Direction of Payment Loss Address: i SOL) Tz-( ek14: City: N Insurance / Client: i= Date of Loss: f �Gh C4. 20C l State: H144 Claim Number (if available): Zip: 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 authorizes Insurance Company, herein referred to as "Insurance Company," to pay Provider solely and 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. Property Owned By: Remarks: 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:^,� Printed Name: WProvider's Signature: Client Reviewed Customer Information Form Date: Franchise Legal Name O Y O N d/b/a SERVPRO® of: White: SERVPRO° Yellow: Claims Professional Date ©SERVPRO® INTELLECTUAL PROPERTY, Inc. ALL RIGHTS RESERVED FE -051707 1.0 Each SER VPRCP Franchise is Independently Owned and Operated. t` & Pink: Customer 28000 11/10 • iuss,ichusetts - Dclrar-tmcnt of Public SafctN a Board of Building Regulations an(1 Standards Construction Supervisor License License: CS 67690 Restricted to: 00 GREGG M WHITE 4 CHATBURN RD WINDHAM, NH 03087 Expiration: 2/20/2012 ('4)mmissiuncr Tr#: 16305 td�Qa'C'! Nb�0CD o to. o CD y A a n � CT C CCD to co > a o 0-4 y a v a oo, y �• R G (A M d y C C r � C QQ 0 A C p P7 C o � -U VJ /sl �0xm X03G)0 zO00 rn v= -U D00m O -i -0P 0 N . X m CD X •p N w O cn Io rnr O o "• „ m M O Z m A inZ --1 ;00 'O Q 0 ? �. g jfl �i!tJN m a p y �., 0 o �yy p F' Z p D �( 0 y n - i7 � � C O o Ul td�Qa'C'! Nb�0CD o to. o CD y A a n � CT C CCD to co > a o 0-4 y a v a oo, y �• R G (A M d y C C r � C QQ 0 A C p P7 C o � -U VJ /sl �0xm X03G)0 zO00 rn v= -U D00m O -i -0P 0 N . 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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/D F 03/15/20112011) PRODUCER 603.382.4600 FAX 603.382.2034 Insurance Solutions Corporation 60 Westville Rd Plaistow, NH 03865 Mari al ana Costa THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED KE]0 CORP DBA SERVPRO OF LAWRENCE PO BOX 328 LAWRENCE, MA 01841 INSURERA: Phoenix Insurance Company 25623 INSURER B: Chartl s INSURER C: INSURER D: INSURER E: t,.UV tKAtotb 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADUL INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMIDDfYYYY1 POLICY EXPIRATION DATE IMMIDDIYYYYI LIMITS N. Andover, MA 01810 AUTHORIZED REPRESENTATIVE GENERAL LIABILITY Marialana Costa/MLD EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR A AGE TE PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY JE T LOC AUTOMOBILE X LIABILITY ANY AUTO BA7331L994 10/01/2010 10/01/2011 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? WCS455311 05/01/2010 05/01/2011 I TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1, 000, 000 (Mandatory In NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS t,tK I H-IUAI t KVL.UtK CANCELLATION AVUKU 25 (2009/0T) U 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Joyce Crum IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 85 S. Bradford St. REPRESENTATIVES. N. Andover, MA 01810 AUTHORIZED REPRESENTATIVE Marialana Costa/MLD AVUKU 25 (2009/0T) U 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. From:Patrice FaxID:McDonald Agency Page 4 of 5 Date:3/15/2011 03:01 PM Page:4 of 5 OP ID: PI A`CO�RD" CERTIFICATE OF LIABILITY INSURANCE DAT03115DIYYYY) 1 03115!11 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 608-788-6160 Stanley McDonald Agency IL Inc608-788-701.2 2018 State Road P.O. Box 1446 LaCrosse, Wl 54602-1446 David R. Mc Donald CONTACT NAME: PHONE FAX A1C No Ext): (AIC No): EMAIL PRO PROTDOMEUCE R WHITKE1 CUSTOMER 10 t INSURER(S) AFFORDING COVERAGE NAIC • INSURED KeJo Corporation dba INSURERA: Tudor Insurance Company 37982 Sevpro of Lawrence INSURER B: Travelers Property Casualty 25674 See Note For Named Insured PO BOX 328 INSURER c Lawrence, MA 01842 INSURER D: 03/01/11 03/01/12 INSURER E : INSURER F: PERSONAL & ADV INJURY $ 1,000,00 COVERAGES CERTIFICATE NUMBER: REVISION NUMRER- 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF MMIDDNYYY POLICY EXP MMlDDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR PGP0730650 03/01/11 03/01/12 DAMA'S'S ze c ED PREMISES Ea ocurrence$ 300,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 RO LOC POLICY PECT F $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Perperson) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS H IR ED AUTOS PROPERTY DAMAGE $ (Per accident) $ NON -OWNED AUTOS UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUIIVE OFFICERIMEMBEREXCLUDED? NIA TORY LIMITS, ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below B Property Section 7107P412 03/01111 03/01/12 675,00 B EmployeeDishonesty 7107P412 03/01/11 03101/12 25,0010 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) BENTJE1 Jennifer Bently 64 Salem Street Andover, MA01810 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,ZZ,�'%',ty' O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD From:Patrice FaxlD:McDonald Agency Page 5 of 5 Date:3/152011 03:01 PM Page:5 of 5 SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 Client: Crum, Joyce Property: 85 S. Bradford St. N. Andover, MA 01845 Operator Info: Operator: BWHITE Estimator: White, Brian Business: PO Box 328 Lawrence, MA 01842 Type of Estimate: Sewage Date Entered: 3/14/2011 Price List: MAEM7X MAR11 Labor Efficiency: Restoration/Service/Remodel Estimate: 2011-03-14-1023 SERVPRO® Fire & Water - Cleanup & RestorationTM Like it never even happened. Date Assigned: Home: (978) 683-9500 Business: (978) 688-2242 x 13 = SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691. DESCRIPTION 2011-03-14-1023 Main Level Garage 798.67 SF Walls 1397.00 SF Walls & Ceiling 66.48 SY Flooring 99.83 LF Ceil. Perimeter QUANTITY UNIT COST Height: 8' 598.33 SF Ceiling 598.33 SF Floor 99.83 LF Floor Perimeter RCV DEPREC. ACV 5. Water extract from floor - Cat 3 598.33 SF 1.78 1,065.03 (0.00) 1,065.03 water - aft business hrs 0.31 127.85 (0.00) 127.85 hours 6. Apply anti -microbial agent - after 1,196.67 SF 0.31 370.97 (0.00) 370.97 hours 3/16/2011 Page:2 7. Content Manipulation charge - per 2.00 HR 49.96 99.92 (0.00) 99.92 hour - after hours 13. Clean with pressure/chemical 598.33 SF 0.63 376.95 (0.00) 376.95 spray - Very heavy 15. Clean floor -cleanup,ba -dry-wall, 598.33 SF 0.-3.5 A- ._ 209.42 (0.00) 209.42 4. Tear out wet rywall, -g - - 24.96 SF --- 0 .78 __ _ ---- - __..� ----19.47 _ - (0.00) - .. 19.47 `? disposal__ -- `for 75. Tear out and ba wet insulation g - 24.96 SF__ - 0.57 -�_ 14.23 - -- (0,00) - 4.23_ - - 1 90. Air mover axial fan (per 24 hour 6.00 EA 28.50 171.00 (0.00) 171.00 period) - No monitoring Totals: Garage 2,326.99 0.00 2,326.99 Weight Room 550.67 SF Walls 756.88 SF Walls & Ceiling 22.91 SY Flooring 68.83 LF Ceil. Perimeter Height: 8' 206.21 SF Ceiling 206.21 SF Floor 68.83 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 8. Water extract from floor - Cat 3 206.21 SF 1.78 367.05 (0.00) 367.05 water - aft business hrs 9. Apply anti -microbial agent - after 412.42 SF 0.31 127.85 (0.00) 127.85 hours 10. Content Manipulation charge - per 2.00 HR 49.96 99.92 (0.00) 99.92 hour - after hours 2011-03-14-1023 3/16/2011 Page:2 "- SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 DESCRIPTION CONTINUED - Weight Room QUANTITY UNIT COST RCV DEPREC. ACV 11. Clean floor ��206.21 SF 0.35_".. 72.17- (0.00) 72.17 f12 'fear out trim/base and bag for ---68.83 LF _ 0.98- _ _ _ .67.45 0.31 67.68 -disposal - after bus. hours 20. Content Manipulation charge - per V " X14. Clean with pressure/chemical 206.21 SF 0.63 129.91 (0.00) 129.91 spray - Very heavy 109.17 SF --0.3.5 38.21 - � 22- Tear -out trim/bas e aand b_a_g -f_r _-.-4 -1._v .8 L_F -- 16. Drill holes for wall cavity drying - 15.00 EA 0.61 9.15 (0.00) 9.15 After hrs 109.17 SF 0.63 68.78 spray - Very heavy 17. Block and pad furniture in room - 1.00 EA 79.18 79.18 (0.00) 79.18 Large amount - after hrs 71. Air mover axial fan (per 24 hour 9.00 EA 28.50 256.50 (0.00) 256.50 period) - No monitoring _ 76: Tear drywall, ------- ---- out wet cle_aTup, bag 68.833 SF 0.78,_x_- -53.69- -_ _ .(0.00)-- - - -53.69) or disposal r9.81 t77. "Tear out an`d`bag-wet insulation -'--`17:21 SF 0.57 (0.00) 9.81 Totals: Weight Room 1,272.68 0.00 1,272.68 t-io'4 - i DESCRIPTION Bedroom 1 334.67 SF Walls 443.83 SF Walls & Ceiling 12.13 SY Flooring 41.83 LF Ceil. Perimeter QUANTITY UNIT COST Height: 8' 109.17 SF Ceiling 109.17 SF Floor 41.83 LF Floor Perimeter RCV DEPREC. ACV 18. Water extract from floor - Cat 3 109.17 SF 1.78 194.32 water - aft business hrs 99.92 (0.00) 38.21 19. Apply anti -microbial agent - after 218.33 SF 0.31 67.68 hours 20. Content Manipulation charge - per 2.00 HR 49.96 99.92 hour - after hours 21. Clean floor 109.17 SF --0.3.5 38.21 - � 22- Tear -out trim/bas e aand b_a_g -f_r _-.-4 -1._v .8 L_F -- 0.98_ 40.99 disposal ---after bus -hours _ _ j_ -� .3 _-�" 23. Clean with pressure/chemical 109.17 SF 0.63 68.78 spray - Very heavy (0.00) 1.94.32 (0.00) 67.68 (0.00) 99.92 (0.00) 38.21 _ (0.00)_ _ 40.99 (0.00) 68.78 2011-03-14-1023 3/16/2011 Page:3 SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 DESCRIPTION 24. Drill holes for wall cavity drying - After hrs 25. Block and pad furniture in room - Large amount - after hrs 70. Air mover axial fan (per 24 hour period) - No monitoring J. CONTINUED - Bedroom 1 QUANTITY UNIT COST RCV DEPREC. ACV 15.00 EA 0.61 9.15 (0.00) 9.15 1.00 EA 79.18 79.18 (0.00) 79.18 9.00 EA 28.50 256.50 (0.00) 256.50 78. Tearou wet --d wall,-cleanu ba ry p, g 41.83SF�-1---�'0:78'"�---32:63 1.78 -" -- (0.00)- _ 3263�i for disposal 27. Apply anti -microbial agent - after 16.00 SF 79 Tear out and bag wet insulation _ 10.46 SF 0.5_7_ 5.96 (0.00) 5.96 f 88. Tear out wet non-salv. cpt, cut/bag- 109.17 SF 0.89 97.16 (0.00) J 97.16 Cat 3 wtr-aft bus. hrs C30: Tea- r ou`t`trim/base and.ba for �`- g �11.33'CF`'`� �'" 0:98 -11.10 (0.00) _ 89. Tear out wet carpet pad, cut/bag - 109.17 SF 0.85 92.79 (0.00) 92.79 Cat 3 wtr - aft.bus.hrs 0.63 5.04 (0.00) spray - Very heavy Totals: Bedroom 1 1,083.27 0.00 1,083.27 Closet 3' T 2'8"'T ry Clos � m m 1 F-2'10" DESCRIPTION 90.67 SF Walls 98.67 SF Walls & Ceiling 0.89 SY Flooring 1.1.33 LF Ceil. Perimeter QUANTITY UNIT COST Height: 8' 8.00 SF Ceiling 8.00 SF Floor 11.33 LF Floor Perimeter RCV DEPREC. 26. Water extract from floor - Cat 3 8.00 SF 1.78 14.24 (0.00) water - aft business hrs 27. Apply anti -microbial agent - after 16.00 SF 0.31 4.96 (0.00) hours 29. Clean floor 8.00 SF 0.35 2.80 (0.00) C30: Tea- r ou`t`trim/base and.ba for �`- g �11.33'CF`'`� �'" 0:98 -11.10 (0.00) _ 1 disposal -. afteFbus`hours- 31. Clean with pressure/chemical 8.00 SF 0.63 5.04 (0.00) spray - Very heavy 32. Drill holes for wall cavity drying - 10.00 EA 0.61 6.10 (0.00) After hrs 69. Air mover axial fan (per 24 hour 3.00 EA 28.50 85.50 (0.00) period) - No monitoring 2011-03-1.4-1023 3/16/2011 ACV 14.24 4.96 2.80 11.10 5.04 6.10 85.50 Page: 4 SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 DESCRIPTION CONTINUED - Closet QUANTITY UNIT COST RCV DEPREC. ACV 80. Tear out wet drywall, cleanup, bag 11.33 SF 0.78 8.84 (0.00) 4� for disposal 81. Tear out and bag wet insulation 2.83 SF 0.57 .1.61 (0.00) Totals: Closet 140.19 0.00 140.19 4'6" -I T 4' z" Ify � CV B� - 1 4'4" tau Bath 208.00 SF Walls 244.81 SF Walls & Ceiling 4.09 SY Flooring 26.00 LF Ceil. Perimeter Height: 8' 36.81 SF Ceiling 36.81 SF Floor 26.00 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 34. Water extract from floor - Cat 3 36.81 SF 1.78 65.52 (0.00) 65.52 water - aft business hrs 35. Apply anti -microbial agent - after 73.61 SF 0.31 22.82 (0.00) 22.82 hours 37. Clean floor 36.81 SF 0.35 12.88 (0.00) 12.88 38. Tear out trim/base and bag for 26.00 LF 0.98 25.48 (0.00) 25.48 disposal - after bus. hours 39. Clean with pressure/chemical 36.81 SF 0.63 23.19 (0.00) 23.19 spray - Very heavy 41. Block and pad furniture in room - 1.00 EA 79.18 79.18 (0.00) 79.18 Large amount - after hrs Totals: Bath 229.07 0.00 229.07 2011-03-14-1023 3/16/2011 Page:5 '1"° 2.M SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 Living 578.67 SF Walls 905.33 SF Walls & Ceiling 36.30 SY Flooring 72.33 LF Ceil. Perimeter Height: 8' 326.67 SF Ceiling 326.67 SF Floor 72.33 LF Floor Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 42. Water extract from floor - Cat 3 326.67 SF 1.78 581.47 (0.00) 581.47 water - aft business hrs 43. Apply anti -microbial agent - after 653.33 SF 0.31 202.53 (0.00) 202.53 hours 44. Content Manipulation charge - per 2.00 HR 49.96 99.92 (0.00) 99.92 hour - after hours 45. Clean floor__ 326.67 SF 0.35 114.33_ (0.00) 114.33 . Tear out tri _ 4 m_/base and_ bag for ---•72.33,LF _ 0.98 _ _ _ 70.8.8 _ 70.88_ j disposal - after bus. hours _ _ 47. Clean with pressure/chemical 326.67 SF 0.63 205.80 (0.00) 205.80 spray - Very heavy 48. Drill holes for wall cavity drying - 15.00 EA 0.61 9.15 (0.00) 9.15 After hrs 49. Block and pad furniture in room - 1.00 EA 79.18 79.18 (0.00) 79.18 Large amount - after hrs 68. Air mover axial fan (per 24 hour 15.00 EA 28.50 427.50 (0.00) 427.50 period) - No monitoring 72. Dehumidifier (per 24 hour period) - 3.00 EA 101.25 303.75 (0.00) 303.75 XLarge - No monitoring X82 -Tear" " eut wt drywall, cleanup, bag_ _ - - 72. -- SF'--`- ' M0.78 1T56.42 (0.00) 56.421 'for disposa 3 "Tear out_and.bag wet insulation -�3 17 SF 0.57.__ ___ ___._20.62 (0.00) _ _ _ 20.62 Totals: Living 4' 2" :: F 5° I Hall q 9Hall' N T 202.67 SF Walls °'1 l 229.94 SF Walls & Ceiling 3.03 SY Flooring Closet 2 25.33 LF Ceil. Perimeter DESCRIPTION QUANTITY UNIT COST 2,171.55 0.00 2,171.55 Height: 8' 27.27 SF Ceiling 27.27 SF Floor 25.33 LF Floor Perimeter RCV DEPREC. ACV 2011-03-14-1023 3/16/2011 Page:6 _ - SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 DESCRIPTION CONTINUED - Hall QUANTITY UNIT COST RCV DEPREC. ACV 50. Water extract from floor - Cat 3 27.27 SF 1.78 48.54 (0.00) 48.54 water - aft business hrs 64.46 SF 1.78 114.74 (0.00) 114.74 51. Apply anti -microbial agent -after 54.54 SF 0.31 16.91 (0.00) 16.91 hours 128.92 SF 0.31 39.97 (0.00) 39.97 53. Clean floor 27.27 SF 0.35 9.54 (0.00) 9.54 54��.0� ut tr_ i a3ftd-bag-for��--�"23.33LF 64.46 SF __.________._f--._..__ 0.98 24.82 � (0.00) - ^24:82 j `m%base disposal -after bus. hours' 32.83 LF - _ - _--- " -- 5-2-1-7 55. Clean with pressure/chemical 27.27 SF 0.63 17.18 (0.00) 17.18 spray - Very heavy 64.46 SF 0.63 40.61 (0.00) 40.61 56. Drill holes for wall cavity drying - 15.00 EA 0.61 9.15 (0.00) 9.15 After hrs 57. Block and pad furniture in room - 1.00 EA 79.18 79.18 (0.00) 79.18 Large amount - after hrs 84. Tear out wet drywall, cleanup, bag 25.33 SF 0.78 19.76 (0.00) 19.76 for disposal 85. Tear out and bag wet insulation 6.33 SF 0.57 3.61 (0.00) 3.611 Totals: Hall 228.69 0.00 228.69 I 10'3" Closet 2 Height: 8' 262.67 SF Walls 64.46 SF Ceiling 327.13 SF Walls & Ceiling 64.46 SF Floor 7.16 SY Flooring 32.83 LF Floor Perimeter 32.83 LF Ceil. Perimeter DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 58. Water extract from floor - Cat 3 64.46 SF 1.78 114.74 (0.00) 114.74 water - aft business hrs 59. Apply anti -microbial agent - after 128.92 SF 0.31 39.97 (0.00) 39.97 hours 61. Clean floor 64.46 SF 0.35 22.56 (0.00) 22.56 62. Tear out trim/base and bag for 32.83 LF 0.98 32.17 (0.00) 5-2-1-7 disposal - after bus. hours 63. Clean with pressure/chemical 64.46 SF 0.63 40.61 (0.00) 40.61 spray - Very heavy 2011-03-14-1023 3/16/2011 Page:7 -V201SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 DESCRIPTION CONTINUED - Closet 2 QUANTITY UNIT COST RCV DEPREC. ACV 64. Drill holes for wall cavity drying - 15.00 EA 0.61 9.15 (0.00) 9.15 After hrs 67. Air mover axial fan (per 24 hour 3.00 EA 28.50 85.50 (0.00) 85.50 period) - No monitoring Totals: Closet 2 344.70 0.00 344.70 Total: Main Level 7,797.14 0.00 7,797.14 Job DESCRIPTION QUANTITY UNIT COST RCV DEPREC. ACV 2. Equip. setup, take down & 2.00 HR 64.81 129.62 (0.00) 129.62 monitoring - after hrs 3. Equipment setup, take down, and 3.00 HR 43.16 129.48 (0.00) 129.48 monitoring (hourly charge) 4. Haul debris - per pickup truck load - 1.00 EA 140.00 140.00 (0.00) 140.00 including dump fees 66. Air mover axial fan (per 24 hour 1.00 EA 28.50 28.50 (0.00) 28.50 period) - No monitoring 73. Negative air fan/Air scrubber (24 3.00 DA 73.25 219.75 (0.00) 219.75 hr period) - No monit. Totals: Job 647.35 0.00 647.35 Line Item Totals: 2011-03-14-1023 8,444.49 0.00 8,444.49 201.1-03-14-1023 3/16/2011 Page:8 SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 Grand Total Areas: 3,026.67 SF Walls 1,376.91 SF Floor 0.00 SF Long Wall 1,376.91 Floor Area 1,428.00 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length 1,376.91 SF Ceiling 152.99 SY Flooring 0.00 SF Short Wall 1,467.19 Total Area 158.67 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length 4,403.58 SF Walls and Ceiling 378.33 LF Floor Perimeter 378.33 LF Ceil. Perimeter 3,026.67 Interior Wall Area 0.00 Total Perimeter Length 2011-03-14-1023 3/16/2011 Page:9 -v !` =" SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 Line Item Total Material Sales Tax Replacement Cost Value Net Claim Summary 8,444.49 @ 6.250% x 227.95 14.25 $8,458.74 $8,458.74 White, Brian 2011-03-14-1023 3/16/2011 Page: 10 -1929= SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 Recap by Room Estimate: 2011-03-14-1023 Area: Main Level Garage 2,326.99 27.56% Weight Room 1,272.68 15.07% Bedroom 1 1,083.27 12.83% Closet 140.19 1.66% Bath 229.07 2.71% Living 2,171.55 25.72% Hall 228.69 2.71% Closet 2 344.70 4.08% Area Subtotal: Main Level 7,797.14 92.33% Job 647.35 7.67% Subtotal of Areas 8,444.49 100.00% Total 8,444.49 100.00% 2011-03-14-1023 3/16/2011 Page: 1.1 ! � SERVPRO of Lawrence PO Box 328 Lawrence, MA 01842 800 535-6322 Tax Id# 02-0353691 Recap by Category Items Total % CLEANING 1,349.37 15.95% CONTENT MANIPULATION 399.68 4.73% GENERAL DEMOLITION 849.49 10.04% WATER EXTRACTION & REMEDIATION 5,845.95 69.11% Subtotal 8,444.49 99.83% Material Sales Tax @ 6.250% 14.25 0.17% Total 8,458.74 100.00% 2011-03-14-1023 3/16/2011 Page: 12 cz Le Z r cn cl PL. Location soaI4 No. e� Ip Date Check #53 4/ 7,5� 23979 Build%fnspector TOWN OF NORTH ANDOVER Certificate of Occupancy $ S CHUst Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #53 4/ 7,5� 23979 Build%fnspector