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HomeMy WebLinkAboutBuilding Permit #669-15 - 89 BRIDLE PATH 2/26/2015BUILDING PERMIT No °Tli qti TOWN OF NORTH ANDOVER 1 3� yE�t' . _}:6'6 oL APPLICATION FOR PLAN EXAMINATION 'tip Permit No#: Date Received �gSSACINUS � Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION 9J C1, Vr d.l ;?ofi\-, j Pri t PROPERTY OWNERliS�e\ i Print 100 Year Structure yes n MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village ves n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building tg One family ❑ Addition 0 Two or more family ❑ Industrial ''Alteration No. of units: ❑ Commercial -g Repair, replacement ❑ Assessory Bldg ❑ Others: 0 Demolition 0 Other tic ❑ Well El Floodplain El Wetlands El Watershed District < jSe :V ater S ewer DESCRIPTION OF WORK TO BE PERFORMED: Identification - Please Type or Print Clearly OWNER: Name: rsbyD-t~C Phone: X1-1 - tM31 Address: OR, 3rk ak#,_ Contractor Name:1.6_,_,:._. M.._,, W 6 Phone: Address: V101 fist JT $ fi, r t�h,, A•.,.d� 1�.. Supervisor's Construction License: 0S-31^41 Exp. Date: Home Improvement License: Exp. Date ARCHITECT/ENGINEER "►-r2 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: $_ °( k3 FEE: $ \k6, Uy Check No.: 1Receipt No.: ZY`i-off NOTE: Persons contractin with unreg' ter c contr ctors do not have access to the guaranty fund `Signature of Agent/Owner i nature of contract BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Prir t�' PROPERTY OWNER N\e,rS�.t \l h Print 100 Year Structure yes' MAF ( __PARCEL-- ZONING DISTRICT:�W_1storic Distract .yes e_ Mnrhina'Shrin` hlinna vac, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ig One family ❑ Addition ❑ Two or more family ❑ Industrial 'VAlteration No. of units: ❑ Commercial ❑ Others: -g Repair, replacement ❑ Assessory Bldg ❑ Demolition ❑ Other Se tic, ❑ Welf{OTF,loodplain I❑,1Netlands 0 Watershed 'Water ewer �„ utbL;KIF I ION OF WORK TO BE PERFORMED: C_4e-x.,.'1.4 P 40 � 2� .,,.-� a �\,e if , 1� ., s l �- s nw� s lz.`\ ��C r `oov,_ Identification - Please Type or Print Clearly OWNER: Name: Phone: b11- IM3 k -Zen Address: OR, 3 rck 6t_ N 4,N Contractor Name:14.�:_ M�,..,�4,lRh.orie _Zj: L�ti X533 t gpe:,rvtsor s Construction L=license:, O S3 U `� Q1 t, +Exp D;ate;_ - . - .. _ aHome.�lmovem_e,nt{License:,,r f } t P. o \ "L`'1 iExp Date: r, .2q t, 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: $ �'& S -D FEE: $ _ \ t O , 00 z Check No.: ��`� Receipt No.: � 0 NOTE: Persons contractin with Lnreg' ter contrctors do not have access to the guarantyfund ature of Agent/Owner i nature of contract Location C t No. ,Pu 1— � !� Date - ' Check # )-(' 2 b 6 b 7 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee $ TOTAL 1 $ Building Inspector Location C� No. wtJ t�— Date r { Plans Submitted ❑ Plans Waived-�j 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 Signature COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS r' Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comm Conservation Decision: Comments r Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site yes Located at 124 Main Street Fire Department signature/date COMMENTS Located 364 Usgood Street no �l El Plans Submitted ❑ Plans Waive` 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 Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH COMMENTS Reviewed on Signature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comments Comments Water & Sewer Connection/signature & Date Driveway Permit DPW Town Engineer: Signature: Locatea 3154 VSgOQU JueGt IFIRE DEPARTMENT Temp Dumpstergn site dyes . s (- 'Located: at 124tMainrStreet g y - %, a DepartmentRsignature.date _ _ _. --__ tCOMMENT�S- I0 1 [It lM� Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, avast 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 aepartment use ® Notified for pickup Call Email Date Time Contact Name, Doc.Building Pennit 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 ❑ 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/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) ❑ 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 o 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 in N J a 2 LLz o 0 aui 0 lb Y 0 LL N ++ N _ F- w tail Z 0 oa� fY0 C LL OA W v CC C U C LL O nW. N Z Z z = L LY LL 0 a v1 Z a U LU L UO (r U 'L (%j LL cc U a z L 7 (L' = LL � a W 5 LJ. i L:D Z ai N l7 Y O N o � �o Q. L Q d � Q • aF O N V E Q. L � yam.. O E -tea= > 0 d i _ O O > 0-0 _ = V Q -a cn O Z Q. .0 O O _ 3 c c H L Q Q O V cc m duo o = L ca as = as 0 y � 2 _ 0 .g „, _ � .Q _ 0 E � :E 2 v�.__� a . 0 O t - C. O U 2 Z 50 m coZ LU N) w IL x LLIG W CL 0 LU Z Z I. v, r cn Z 0 U) J ES w L CL W U) r_ • 98 Forest StreetKledln.Murphy, 0 North Andover, MA 01845 PH: 978-688-5335 Building Contractor 0FAX: 978-688-7207 Proposal To: Marshall Abbott 89 Bridle Path North Andover, Ma. 01845 From: Kevin Murphy Citi: Date: 2/25/2015 Job: Family room renovation Date of plans: None Archiltect: 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, Roan 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 2/25/15. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 3/2015. 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 Sheet North Andover, MA 01845 PH: 978688S33a FAX 978688-7207 General Proposal is to renovate existing family room. Permit will be obtained by contractor. Demolition Page 2 of 4 All cabinets and raised panels will be removed. Flooring and sub floor will be removed. Existing walls and ceilings to remain. Fireplace hearth will be cut back to meet code. Heating/Air Conditioning Existing heat will be relocated / replaced as required. No allowance has been made for any air conditioning. Interior Trim/Doors Any interior trim required will be supplied and installed to match existing. No allowance has been made for any door units. Painting Walls will be patched and painted. Ceiling and trim will also be painted. One coat of primer, and two coats of finish will be applied. Flooring Hardwood floors will be supplied, installed and finished to match existing. Three coats of oil based finish will be applied. Waste Removal All demolition / construction debris will be disposed of by contractor. Items Not Included There has been no allowance made to completely gut the room, provide any masonry work, insulation, plastering, or electrical work. Kevin Murphy Building Contractor 98 Forest Street North Andover, MA 01845 PH: 978685.c&% FAX 97868&7207 Section IV - Price Schedule Page 4 of 4 We hereby propose to fumish material and labor — complete in Accordance with above specifications for the sum of ..................................... $ 9850 Pavment to be made as follows: Percentage/item Description Amount 1 Deposit / permit obtained $1850 2 Painting complete $5000 3 Floors finished /job complete $3000 Total 13 1 1 $9,850.00 Notice: No agreement far Home improvement contracting wok shall require a dawn 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 oder 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 SI N THIS CONTRACT IF THERE ARE ANY BLANK SPACES Signatur ADate Z l Signature Date /ie �pomnsaracu��auJeL1 Office of Consumer Affairs & Business Regulation OME IMPROVEMENT CONTRACTOR i egistration: 1p1874 Type: xpiration::.-:6/29/2016 Individual I KEVIN MURPHY Kevin Murphy 98 FOREST ST. N. ANDOVER, MA 01845 Undersecretary Massachusetts - Department of pu.blic.Safety -Board of Building Regulations and Standards Construction Supervisor License: CS -053099 ��.A P KEVIN W Ww#v n �% 98 FOREST ST North Andover M -A 0 �c Expiration 06129/2015 ' Commissioner The Commonwealth of Massachusetts Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: `�R St,., .— City/State/Zip: ►J,,, Ivy. u-tSPhone#: 1i1'5- 3 3 Are you an employer? Check the appropriate box: L$9 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. ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ 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. i Homeowners who submit this affidavit indicating they ate 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:. Gv✓� SNS , c,, Policy # or Self -ins. Lie. #: l.Lt% w G 51:1 64-f Expiration Date: — � \ \ l ,5 Job Site Address: ?°I P.t�, City/State/Zip: Nv IA,4 � , N-�. U �2 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 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 hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct Signature \o �� Date: 2.1� Phone #• T -1V - b b qi L 3 5" Official use only. Do not write in this area, to be completed by city or town official. 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 #: -4 � hr CERTIFICATE OF LIABILITY INSURANCE DIYYYY 6/25/20 4 Y) 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 polity(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 CONTACT Sandi Munroe ME PHONE 978 683-8073 FAC N .(978) 683-3147 E-MAIL sand! mpro ertslnsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING REMODELING 169 BOXFORD STREET NORTH ANDOVER, MA 01845 INSURERB: GUARD INSURANCE INSURER : INSURER D: INSURER E INSURER F COVFRAGFS (FRTIFICATF NIIMRFR- RFVIRIr)N NIIMRFR• 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. INS LTR TYPE OF INSURANCE UL I WOK I POLICY EFF POLICY EXP LIMBS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 a 500,000 I CLAIMS -MADE OCCUR PREMISES E r $ IOEDE)w one "son $ 1510,00 BOPI068945 1/22/13 1/22/14 A PERSONAL&ADV INJURY $ INCLUDED GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY a PO - JET ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER* AUTOMOBILE LIABILITY COMBINED SINGLEUMIT $ CC dent BODILY INJURY (Per person) $ ANYAUTO MCA7013608 1/23/14 1/23/15 ALLOWNED SCHEDULED X BODILY INJURY (Per accident) $ A AUTOS AUTOS PROPERTY DAMAGE $ NON -OWNED HIREDAUTOS AUTOS Peracddent UMBRELLA LIABOCCUR HCLAIMS-MADE EACH OCCURRENCE $ 1,000,000 AGGREGATE $ r , A EXCESS LIAB CUP9145304 11/22/1311/22/14 0 WORKERS COMPENSATION X PER I I OTH- AND EMPLOYERS LIABILITY Y N STATUTEER B ANY PROPRIETOR/PARTNERIEXECUTIVE NIA E.L. EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) KEWC527844 7/01/14 7/01/15 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes, descrDeunder 500 000 DE IPTION F P RATIONSbelE.L. D -POLICY LIMIT , DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 10 1, Additional Remarks Srh ad Lie, may be attached if more spare i5 req Ldred) CFRTIFICATF HOI nFR CANCFI I ATInN 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 PROVISIONS. I AUTHORIZED REPRESENTATIVE M N keu*.- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD