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Home My WebLink AboutBuilding Permit #419-16 - 92 PRESCOTT STREET 10/5/2015 BUILDING PERMIT NORTH �wt�eo 6s 1.0 TOWN OF NORTH ANDOVER o� y °�, APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received gSSACHU`�� Date Issued: M 5 5 IMPORTANT: Applicant must complete all items on this page LOCATION __. Print PROPERTY OWNER a .,r v .- �,�ti. -_ �2- Pant - 100�Year Structure yes no MAP Q.- PARCEL._/——ZONING DISTRICT:__ Historic District yes rro _.._rMachine Shop Village yes. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building IpOne family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic El Well; ❑ Floodplain 0 Wetlands ❑ Wa-tershed District ate-r/Sewer - - _ DETO BE PERFORMED: e, � `CRIPTIO� OF WORK Identification- Please Type or Print Clearly OWNER: Name: Phone: �'1 Address: 'i Contractor Name:�Ce ,4.,.. 1� ,,:_,,,Vhone: ��1 V_ v `S 3 Address: r t Supervisor's Construction License: __-__Q,j_�_041 V\ _._ _ Exp. Date: Home'Improvement License. Exp. Date;,.��61'L , ARCHITECT/ENGINEERPhone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 1�( . J O FEE: $ \'1 10 Check No.: azoq,( Receipt No.: 1x NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund � 4 Signature of Agent/Owner rsne Signature of contracto�i � 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 o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses o 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 ❑ Building Permit Application ❑ Certified Surveyed Plot Plan o Workers Comp Affidavit o Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract o 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 o Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract o 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 Plans Submitted ❑ Plans Waive Certified Plot Plan ❑ Stamped Plans ❑ TYPE"OF SEWERAGE DISPOSAL ( Public Sewer ❑ Tanning/Massage/Body Art ❑ Swinuning 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 R 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: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on. site yes _ no _ Located at 124 Main Street Fire Department signature/date COMMENTS _ i Dimension � I 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 Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Location No. Date ��•+ qq-,11nn - TOWN OF NORTH ANDOVEFI d Certificate of Occupancy $ � Building/Frame P rmi Permit Fee $�7� •O a ' Foundation Permit Fee $ Other Permit Fee $ ' TOTAL $ Check# ' r v i? 2 94 5 4 l�ding Inspector NORTH own of s E 1, ndover No. 411 2 o - SAKE h , ver, Mass, S /� COC KICKl WICK y1' ORATED S U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT Cv, c�� )I:SIVK: BUILDING INSPECTOR ....... ...... ............................................................................. Foundation has permission to erect .......................... buildings on .��....��'..�..�. '-.Z:'/.. ............................... / Rough to be occupied as ...............Rif.:� ur: /_/� `......31 sa 471 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. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service ..........T ..... . .�!/•fr�ti,....�............................. oy�-4HG 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 Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. 98 Forest Street �� K-e V �.!� � urp,h—,y • No:h Andover, A 01845 Building Contractor 0FAX:978-6W7207 Proposal Ta Don McDaniel/Carol Disney 92 Prescott Street An Home imp wement Contractors and subcontractors North Andover, Ma. 01845 in home Prounless ChWer 142A of the general laws,nnrst be registered with the Corrmronwealth of Massachusetts.Inquiries about registration and status stauid be made to the Director,Home Improvement contract Registration,One Ashburton Place, From: Kevin Murphy Room 1301,Boston,MA 02108.(617}727 8598 CC: , Date: 10/5/2015 Job: Bath Remodel Date of plans: None . Architect: None Location: Same Section 1-Work Schedule 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 9/15/15. Barring Delay caused by circumstances beyond Contactors,control,the work will be completed by 11/15/15.The owner hereby acknowledges and agrees that the scheduling dates are appropmate 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 fumished 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 coned,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 Page 2 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:97845885335 FAX 97888&7207 General Proposal is to renovate existing three fixture bath. Permits will be obtained by contractor. Demolition Existing bathroom will be completely gutted. Building Any miscellaneous materials required to fix rotted floor will be supplied by contractor. Plumbing Plumbing required to remodel bathroom will be provided. Fixtures to remain in same locations. Copper pan for new tile shower will be supplied and installed. Plumbing fixtures to be supplied by owner, installed by contractor. Electrical ti Electrical work required to wire bathroom to code will be provided. New Panasonic fan / light will be supplied and installed.Any surface mounted fixtures(wall sconces)to be supplied by owner, installed by contractor. Insulation Fiberglass insulation will be installed in exterior wall. Plaster Bathroom will be blueboarded and skimcoat plastered. Interior Trim/Doors Interior trim will be supplied/installed to match existing. Flooring Tile floor and shower will be supplied and installed. An allowance of$7 per square foor has been included for tie materials. Other Allowances An allowance of$2000 has been included to supply and install glass shower door. Painting There has been no allowance made for any painting. Waste Removal All demolition/construction debris will be disposed of by contractor. i l +Kevin mmflphy Page 4 of 4 Building Contractor 98 Forest sweet North Andover,MA 01845 PH:978688-5335 FAX:9786887207 Section IV-Price Schedule We hereby propose to furnish material and labor-complete in Accordance with above specifications for the sum of...... ...... ... ... ... ... ... ... .......$ 14,700 Payment to be made as follows: Percentage/Item Description Amount 1 Permit obtained / demolition complete $2700 2 Plastering complete $5000 3 Tile complete $4000 4 Job 100%o complete $3000 Total4 $14,700.00 —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 andlor otherwise obtain delivery of spade]order materials and equipment,whichever is greater Contractor: Kevin Murphy ! 98 Forest Street No.Andover, MA 01845 Registration No: 101874 I 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 Signature . Date � � /� Signature Date The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA-021X4-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED.WITH THE PERVIITTING AUTHORITY. Anolicant Information Please Print Letaibly Name(Business/Organization/Individual): yo—Alt- Address: '`3,- Fit»-V'V S City/State/Zip: tic— o k."TPhone Are you an employer?Check the appropriate box: Type of project(required): 1T61 am a employer with employees(full and/or part fume).* 7. F-1 New construction 2.FJ I am a sole proprietor or partnership and have no employees working forme in 8. Remodeling any capacity.[No workers'comp.insurance required.] 3.❑I am a homeowner doing all work myself.(No workers'comp.insurance required.]t 9. ❑Demolition 10 Q Building addition 4.0 1 am a homeowner and-mill be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I Ln Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.] 6.❑We are a corporation and its officers have exercised their right o£exemption per MGL c. 14.E]Other 152,§I(4),and we have no employees.[No workers'comp.insurance required.) *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 are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that checkthis 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. lain an erarployer that is pi-opliing svorlcers'compensation insra-artce for rrry employees. Below is thepolicy andjob site information. �+ Insurance Company Name: (��.•V� �•.r✓..f- t,/^ C, ` Policy#or Self-ins.Lie.#: t<_0 C— 6 i "1 3 LI Expiration Date: Job Site Address: `�� ?t`.-o City/State/Zip: tJM (;\ N-.0,, ,'U\. 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. I do lrereb certify under the pains and penalties of peryury that the information provided above is true and correct Si nature: Date: I. sd Phone#: i Official use only. Do not write in this area,to be completed by city or tmvn 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 i Contact Person: Phone#: DATE(MMrDDflYYY) C R` CERTIFICATE OF LIABILITY INSURANCE F711512015 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATIONONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELYOR NEGATIVELY AMEND,E)(TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVB)R PRODUCER,AND THE CERTIFICATEHOLDER. IMPORTANT:H the certificataholder Is an ADDITIONALINSURED,the poliey(les)must be endorsed.H SU13ROGATIONS WAIVED,subject to the tennsandconditonsofthe pWkyt erWnpolideemyrequi a mdorsementAstatemeMon thlsceNNeatedoesnot mMerrlghtstothe ceMNcateholder In lieu of such endorsement(s). PROOl10ER CNAMEONTACT Sandi Munroe M P ROBERTS INS AGCY INCPHONE (978)683-3147 FAx 1060 Osgood Street INCE (978)683-3147 978)683-8073 �,�. 4 ADDRESS: sandi@mprobertsinsurance.com North Andover, MA 01845 INSURER(S)AFFORDING COVERAGE NAICs INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING 6 REMODELING INSURER B: GUARD INSURANCE 169 BOXFORD STREET INSURERC: NORTH ANDOVER, MA 01845 INSURERD: INSURER E INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE REM N ISSUED 7b THE INSURED NAMED ABOVE FOR TETE POLICY PERIOD INDICATED. NOTWRHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUE)OR MAY PERTAIN,TI-E INSURANCE AFFORDED BY THE POLICIES DESCRIBE)HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSANDCONDITIONS OF SUCH POLICIES LIMITS SHOWNMAY HAVESEEN REDUCED BYPAID CIAI?n Mr wne POLICY EFF POLICY EXP �a TYPEOFINSURANCE POLICY NUMBER LIMITS X COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $ 1 000,000 ClA1MSMADE D OCCUR PREMISES Ea aarterrce $ 500,000 - MEDEXP(Any—P—) $ 15,000 A BOPI068945 1/22/14 1/22/15 PERSONAL&ADV INJURY s INCLUDED GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT QLOC PRODUCTS-COASr/OPAGG S 2,000,000 OTHER $ AUTOMOBILE LIABILITY COE_aMBINEacddDSINGLELIMIT $ 1,000,000 ANYAUTO BODILYINJURV(Per Parson) $ ALL OWNED SCHEDULED MCA7013608 1/23/15 1/23/16 BODILY INJURY(Per acddent) S jI, AUTOS X AUTOS NON-OWNED PROPERTY DAMAGE HRiED AUTOS AUTOS Per ecddent $ S UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000 A IXCESS LIAR CLNMSi�iAflE AGGREGATE $ 1,000,000 CUP9145304 1/22/14 1/22/15 DED RETENTION $ E WOR RS COMPENSATIONX PER YIN OTK AND EMPLOYERSTIABILITY STATUTE ER B � N NIA E. EACH ACCIDENT $ 500,000 (M— "L. .NH) KEWC633734 7/01/15 7/01/16 E.L.DISEASE-EJ EMPLOYEE s 500,000 i`y.%desibae.dr500 000 DESCRIPTION OFOPERATIONS below EJ-DISEASE-POLICY LIMIT $ DESCRIPTION OFOPERATONS I LOCATIONS I VEHICLES(ACORD 101,AddMonal RenwaftSctredrde,may be atxtmd B ore spece Is regaled) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER - SHOULD ANY OF TFE ABOVE DESCRIBED POLICIES BE CANCELLED BERNIE THE. DDPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE I i ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD25(2014/01) _ The ACORD name and logo are registered marks of ACORD. t{ Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License: CS-053099 KEVIN W MURPI ft 98 FOREST ST North Andover M-A 01Wjij Expiration Commissioner 06/29/2018 k l A Y �par��waacrsea�tl,.o�C�/f/Z�ci�aac��me, Offce o(Consumer Affairs&Busihess Regulation OME IMPROVEMENT CONTRACTOR egistration: 101874 Type: xpiration:,,:6/29/2016 Individual KEVIN MURPHY Kevin Murphy 98 FOREST ST. N.ANDOVER, MA 01845 Undersecretary 9/10/2015 Fwd:Department of Public Safety Authorized Payment Confirmation-michellerochel4@gmail.com-Gmail • ' Click h Gmail COMPOSE Fwd: Department of`Public Safety Authorized Payment Col ' Inbox(2,079) Kevin Murphy P Y Starred to me Important ------Forwarded message--------- Sent Mail From: <ConveniencePayClientSupport hp com> Drafts(4) Date: Wed, Jun 10, 2015 at 5:42 AM Subject: Department of Public Safety Authorized Payment Confirmation Facebook " To: kevinmurphybuildinaO-amail.com Notes Personal . This is an electronically generated acknowledgement of your payment to Recipes Department of Public Safety Payment. Please print this message or Travel save it on your computer for future reference. More Here is your payment information: License Number: CS-053099 Payment Date/Time: 6/10/2015 5:37:19 AM (ET) Payment Amount: $100.00 Convenience Fee Amount: $2.49 Method of Payment: Visa Card Number: ****3909