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Building Permit # 3/31/2015
NORTFr BUILDING PERMIT O.1 �.y I TOWN OF NORTH ANDOVER APPLICATION FOR PLAN,EXAMINATION A1�T yy Permit No#: I Date Received 04 7q AERATED rPP`�(� Date Issued. i IMPORTANT: Applicant must complete all items on this page r".3" r � _PENN r ^ ` r 1 � O ✓A LIQ �'"Pf ar�r "" "r - � :� � t'�✓.l r��'yl ��������`�'%` r P Irl x r �����Stfl�.lC Ur +r. t� 25�`✓i� ��sr �?`F``�' MA ZON1KT- 1r RaC`T �,.%�. Hc DIStIIC� ?, eS� , nOr k �.. ..,., .� r. ✓rri �k" ,r.fr�.'�ttz�� a ... ✓ 1 ,, a/a gL � „� Z r- -; �ir✓� �'"' ���.,;r �'.:��� �-r `", r' f,� ��"`p.�� F tAORTH Im 711, d o v e r I own 01 � LAKE h ver, ass, COCmc"t WICK ,9 AD4A.rED "x�,��5 S u BOARD OF HEALTH PERMIT T LD Food/Kitchen Septic System THIS CERTIFIES THAT ................ .......,.. .........0.14. .... ...k.440.kv.............................. BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on ... Rough to be occupied as . `. ® .�k.... W ...... 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final ® EXPIRES ® S Rough ELECTRICAL INSPECTOR LES CTI T Service ................... . .... ...... .... .................................... Final BUILDING INSPECTOR GAS INSPECTOR ccupancy Permit Required t® 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. A. F. Watson General Contracting Estimate 3 Edgemont Street Derry,NH 03038 DATE ESTIMATE# Tel. 603-437-6134 1/27/2015 1590 Cell#603-661-5360 NAME/ADDRESS Mike Dambach 27 Clarendon Street North Andover,MA 01845 TERMS PROJECT Due on receipt Kitchen's and Bath ITEM DESCRIPTION QTY COST TOTAL Permit Town of N.Andover building permit fee 500.00 500.00 labor Carpenter's labor prep kitchen per side 62 45.00 2,790.00 1.Demo existing cabinets per side 8hr 2.Strip flooring 8hr.per side 3.Take down wall on rental side patch wall and ceiling as needed.l6hr. 4.Install new wood flooring in kitchen 16hr 5.Open and patch walls as needed for electrical 8hr 6.Misc.Labor set appliances patch in baseboard as needed 6hrs Miscellaneous Miscellaneous materials 80.00 80.00 Flooring Kitchen Flooring allowance about 168 sq.ft 168 3.75 630.00 Sheetrock Tx 8'x 1/2"Sheetrock 6 12.38 74.28 Joint Compoun 5 Gallon bucket Joint Compound 1 16.50 16.50 Subtotal labor&Materials 4,090.78 Cont.fee Contractors 10%Fee profit+overhead 10.00% 409.08 Total per kitchen 4,499.86 labor Carpenter's labor build and install cabinets 96 45.00 4,320.00 3/4"Birch Tx 8'x 3/4"Birch Plywood 10 76.05 760.50 1/4birch 1/4"Birch plywood 8 58.49 467.92 poplar 1"X 8"X F-0"Poplar 80 3.43 274.40 Miscellaneous Miscellaneous 200.00 200.00 hardware Cabinet Hardware 10 drawer slides @$20 slides 25 1 575.00 575.00 hinges @ 15.00 Painting Painting?about$2,800.00****** 0.00 0.00 Plumbing Plumbing: Supply and install necessary drainage+water 1,500.00 1,500.00 piping THANK-YOU A.F.WATSON TOTAL SIGNATURE OWNERS SIGNATURE Pagel A. F. Watson General Contracting Estimate 3 Edgemont Street _ Derry,NH 03038 DATE ESTIMATE# Tel. 603-437-6134 Cell#603-661-5360 1/27/2015 1590 NAME/ADDRESS Mike Dambach 27 Clarendon Street North Andover,MA 01845 TERMS PROJECT Due on receipt Kitchen's and Bath ITEM DESCRIPTION QTY COST TOTAL Electrical Electrical work 1,600.00 1,600.00 Subtotal labor&Materials 9,697.82 Cont.fee Contractors 10%Fee profit+overhead 10.00% 969.78 Total per Kitchen if I build them 10,667.60 labor Carpenter's labor Bath rm. 80 45.00 3,600.00 1.Remove existing fixtures strip floor to sub floor and open sub-floor as needed to plumb new tub/shower 2.Prep walls as needed to install tub/shower. 3.Create linen cabinet recessed into attic space 4.Insulate as needed 5.Close up floor,walls,and ceiling 6.Install cement board tile backer and Tile floor 7.Install base boards as needed Plumbing Plumbing:Supply and install necessary drainage+water 1,900.00 1,900.00 piping Fixtures Bath Fixture's Tub/Shower,Toilet,vanity& 1,250.00 1,250.00 sinktop,tub/shower valve,sink faucet Electrical Electrical work. 850.00 850.00 Fixtures Electrical fixtures Exhaust fan/light and insulated ducting 300.00 300.00 ,vanity light 3/4CDX Fir Tx 8'x 3/4"CDX fir Plywood for patching sub floor after 2 26.53 53.06 plumbing work 3/4"Birch 4'x 8'x 3/4"Birch Plywood 2 53.05 106.10 cement board 3'x 5'x 1/2"Cement Board tile backer 4 13.75 55.00 Thinset Thin set cement 2 37.58 75.16 Tile floor Tile approximate.60 sq.ft. 60 3.50 210.00 THANK-YOU A.F.WATSON TOTAL SIGNATURE OWNERS SIGNATURE Page 2 A. F. Watson General Contracting Estimate 3 Edgemont Street Derry,NH 03038 DATE ESTIMATE# Tel. 603-437-6134 1/27/2015 1590 Cell#603-661-5360 NAME/ADDRESS Mike Dambach 27 Clarendon Street North Andover,MA 01845 TERMS PROJECT Due on receipt Kitchen's and Bath ITEM DESCRIPTION QTY COST TOTAL Sheetrock 4'x 8'x 1/2"Sheetrock 6 12.38 74.28 Joint Compoun 5 Gallon bucket Joint Compound 1 16.50 16.50 Miscellaneous Miscellaneous 120.00 120.00 Subtotal labor&Materials 8,610.10 Cont.fee Contractors 10%Fee profit+overhead 10.00% 861.01 Total Bath 9,471.11 Dumping Charg Disposal fee Allowance 450.00 450.00 Granite Group 1 Granite Tops$58 sq.ft. 31 58.00 1,798.00 Note The Above prices are estimated and will be adjusted to 0.00 0.00 actual costs. THANK-YOU A.F.WATSON TOTA L��-�r1( 66164 $26,886.57 ���� SIGNATURE OWNERS SIGNATURE 3- 31 - 0 Page 3 DATE(MMIDD/YYYY) A�D® CERTIFICATE OF LIABILITY INSURANCE 3/31/2015 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). CONTACT PRODUCER PAUL T MURPHY INSURANCE AGENCY INC NAME: 628 BROADWAY PHONE FAX MALDEN, MA 02148 AIC Ext: AIC No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: LM Insurance Corporation 33600 INSURED INSURER B: ARTHUR WATSON DBA AF WATSON GENERAL CONTRACTING INSURER C: 3 EDGEMONT ST INSURER D: DERRY NH 03038 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 24041091 REVISION NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM POLICY EFF MM POLICY LTR DIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH ODAMAGECCURRENCE $ RENTED CLAIMS-MADE F-1OCCUR PREM SES(E. occurrrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO JECT [—]LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINaccidentED SINGLE LIMIT $ Ea ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS ROPERDAMAGE AMAGE $ NON-OWNED Per accident HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC5-31S-601278-015 1/14/2015 1/14/2016 �/ STATUTE I EERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? Y N 1 A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR ARTHUR WATSON. Workers compensation insurance coverage applies only to the workers compensation laws of the state MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers'compensation coverage CERTIFICATE HOLDER CANCELLATION MICHAEL GANVACH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 27 CLARENDON STREET ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE j } LM Insurance Corporation VVV ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 24041091 CLIENT CODE: 1578924 Lucy Garfield 3/31/2015 9:51:44 A14 (EDT) Page 1 of 1 ��e�pa�wnzoaacuea�l�o�P/l�c�aJ�cc�z«aeM Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date..If found return to: egistration: 118848 Type: Office of Consumer Affairs and Business Regulation Expiration: 4/28/2017 DBA 10 Park Plaza-Suite 5170 o Boston,MA 02116 A.F.WATSON GEN CONTRACTING _ �1 ARTHUR WATSON , 3 EDGEMONT ST ,..c �_ r — ✓ f �Vim/ - DERRY, NH 03038 Undersecretary Not valid without signature Massachusetts -Department of Pubiic 4- zf } Board of Building-.€egulat oft- Stsnda c. r Construttion Supci�icor 1 &2 Family:, License: CSFA-063168 ARTHUR F WAT�bN z 3 EDGEMONT ST DERRY NH 0303-8 '�` Expiration Commissioner 02/12/2016 Massachusetts Home Improvement Sample Contract This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should first obtain a copy of"A Massachusetts Consumer Guide to Home Improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Contractor Information Nae Nam „ Comp a�yr�Ut r" c� Yl) Street Address(4o not use a,Po�st_Otlice Box address) ContractoAISlespersont Owner N e ')I- C,2,1 tytTor State Zip Code Business Address(just include a street address)_ `y, ! v). ➢4f�1" el C�i��S ,._) A (a/�3r o/u/ .e" /it,,/'// <I 433C��9 Daytime Phone Evening Phone City/rown "1 S to Zip Code cA5 6, 16-6 Derr /1 P (-, .3i--35s Mailing Address(It different from above) Business Phone Federal Employer ID or S.S.Number Home inganrem.t Contractor Rte.Numbor E.-pimtion date I,or requiresthen most home imprnrog mntniusd slid regtuodion number The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.) 00�lc;111 AI)C L) (\l C—i(tger' 0241AA ( L641 vim, l Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowners agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of `� ��Date when contractor will begin contracted work. MGL chapter 142A.) 3-14,5 Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,famish the material and labor specified above for the total sum of. M Payments will be made according to the following schedule: $C upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) _ r $ t`�i r t by J/J! or upon completion of 11 Yl j' $ 1 OCCS,0 by 5 /J/ `J or upon completion of 6 � (j /c✓I c'�r rg $ (] jLon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ be paid for ordered before the contracted work begins in order to meet the completion schedule.(**) $ If'be paid for NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express warranty-Is an express warranty being provided by the contractor? ITNo❑Yes fall terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agrcement Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. is Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE OE NY BLANK SPACES!!! T,tlwo i/d�en�tica]copi rthe corarac'sust be completed and signed.One copy should go to dr on The other py shoal be kept by the tractor. Homeoemer's Signature Contractor's Signature s Date Date The Commonwealth of Massachusetts Department of IndustrialAccidents s I Congress Street, Suite 100 Boston,MA 02114-2017 sy`v`�t www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNHTTING AUTHORITY. Applicant InformationC i,., `, Please Print Le ibl Name(Business/Organization/Individual): F W-4750,4J ' T�1, Cod,'oc,b lu ' Address: M b iNJ City/State/Zip: (G 03656 Phone#: ( �� Are you an employer?Check the appropriate box: Type of project(required): 1.�1 am a employer with employees(full and/or part-time).* 7. F1 New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. [q<emodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.FJI am a homeowner doing all work myself.[No workers'comp.insurance required.]t 4.F]I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 []Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.Q 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.Q We are a corporation and its officers have exercised their right of'exemption per MGL c. 14.Q Other 152,§1(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. Homeowners who submit this affidavit indicating they are 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am aiz employer tfiat is providing workers'compensatioiz inszir•ance for•my employees. Below is the policy and job site information. m"', Insurance Company Name: t � Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: �7 l�(Czk o I City/State/Zip: �Y1dL)�" ,�_, /Mq 018 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 herebyof Edere pains and aloes of perjury that the information provided above is true and correct. Si nature: Date: � ��� Phone#: 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#: