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HomeMy WebLinkAboutBuilding Permit # 4/30/2015 BUILDING PERMIT o�"°RT H T T V oL APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received ���gDRaC t1`'''S cy SS� HE'( Date Issued: I RTANT: Applicant must complete all items on this page ,rr r rr r / / r / r/ ,r „✓i r „, ! /i i gin, / r r / r �� � // /r � ✓,i,//./ /�, //i/ r 1, i/ / / ✓ / r r r rr r / / / / r / / / r // / / r rr r / /lrr / ✓ii // r ., r r r r „/, ,,, ,,✓ ,,, a/ r rlr, .., l / ✓ .,✓/,r. /, �, �, ,� / // ,/ / rr/ % //, it„ /, ,// R EL ZO ING DISTRICT i/,//,//,, ,,Histor c D r TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building SOne family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other /r r/rr rrr Septic/'r/❑Well l'// r';; ,' ❑ Floodplairi /❑,Wetlands ' ; ❑„1Nater shed Distract =` //%/r ,, ,,,,,,, ,,,,,,,,,,, „J/,r;,,,,/,G iii, a G,,..%/L%//i.J.%✓1�/�riGir„�,.l,r/�C/✓ra/i,,�,,,,,,i✓,,,., „r is,o,; ,,,, ,,,, ,,,,/ir�,q, /�,,,.� ' i////i/%/„/�ri a/'/�✓rr/r,i�//i /� DESCRIPTION OF WORK TOBEPERFORMED: enta is tion- P ease Type or Print Clearly OWNER: Name: J ,k Phone:` .- M Address: .. / , 77 /r i �//,/,/� /,//%, // //. / r / r / //r ✓ / / rrr., r, ,rr r :✓rr r! ,c,: �l ,•,/,/� r. � �r /r„ -! /./ ,.. /r �i.,. l,r//r���.,r /„ //a��, ,�,o,r� ,..., /r%r /, i/„ �� ro ,r,// r/ r /�,ri 1 i � n./, •r r'i--r�; .,.,,, � ,,, +�/�� L..,,,,G i,r ,... 1. r//i9//,,z�/,/ �i„//`: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERM/T.'$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost. $ FEE: $_ Q Check No.: o Receipt No.: NOTE: Persons contracting with unr ed contractors(Io not have access to the guaranty fund Signature of Agent/Owner , nature of contracto C t4ORTH U 11 U 11duvell O _ T 4LZn 1 LAKE V�+i Mass, CoCMICMEWICK �,9 A°R•areo PP�,��4`� � U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THATBUILDING INSPECTOR .......... .... !i*"v ...... ! . .................. ....... . . ... . ... ... M� Foundation has permission to erect .......................... buildings on ....Y�I.......1s !I.. .. .. .................� �• ........... Rough to be occupied as a ..... � ........ ... ......... ........... A......- 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 I ONT S ELECTRICAL INSPECTOR UNLESS C T TS Rough Service ............. .. .. ... ............................ 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. i 98 Forest Street Kevi,, • North Andover,MA 01845 Murphy • PH:978-688-5335 Building Contractor FAX:978-688-7207 Proposal To: Jen Bilodeau 461 Summer Street All Home improvement Contractors and Subcontractors engaged in home improvement contracting,unless North Andover, Ma 01845 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, From: Kevin Murphy Room 1301,Boston,MA 02108.(617)-727 8598 CC: Date: 4/29/2015 Job: Bath Remodel Date of plans: None Architect: None Location: Same i i 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 4/27/15. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 5/30/15.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 Aftrphy Page of 4 li n di ng 4:o ntn•St':tnar:° 98 Forest Street North Andover,MA 01845 PH:978-688 5335 FAX 978£88-7207 General Proposal is to renovate existing second floor full bath. Permit will be obtained by contractor. Demolition Existing bathroom will be completely gutted. Building Any building materials required for renovation will be provided. Existing window to remain. Plumbing Plumbing required to renovate bathroom will be provided. Fixtures to remain in same location. All plumbing fixtures to be supplied by owner/installed by contractor. Electrical Electrical work required to renovate bathroom will be provided. New Panasonic bath fan/ light will be supplied and installed.Any surface mounted fixtures(vanity lights)will be supplied by owner, installed by contractor. Heating/Air Conditioning Existing baseboard heat will be cut back / replaced as required. No allowance has been made for any air conditioning. Insulation Fiberglass insulation will be supplied and installed. Plaster Bathroom will be blueboarded and skimcoat plastered.Walls will be smooth. Ceiling to match existing. Interior Trim/Doors Interior trim will be supplied and installed to match existing. No allowance has been made for any door units. Bath vanity/cabinets to be supplied by owner/installed by contractor. Painting No allowance has been made for any painting. Flooring Tile floor will be supplied and installed. An allowance of$6 per square foot has been included for tile materials. No allowance has been made for any other tile work(around tub/on walls) . Kevhi Mry Page 3 of 4 Bididing Contractor 98 Forest Street North Aridover,MA 01845 PH:978688-5335 FAX 978688-7207 Waste Removal All demolition/construction debris will be disposed of by contractor. Kevin Murp-h Page 4 of 4 Building c urlg,W,.ontr^�rctor, 98 Forest Street North Andover,MA 01845 PH:9788888335 FAX 97888&7207 Section IV-Price Schedule We hereby propose to furnish material and labor-complete in Accordance with above specifications for the sum of... ... ... ... ... ... ... ... ... ... ... ....$ 13,300 I Payment to be made as follows: Percentage/Item Description Amount 1 Permit obtained / demolition complete $3300 2 Plastering complete $6000 3 Job complete $4000 Total 3 $13,300.0-0-1I "Notice:No agreement for Home improvement contracting work shall require a down payment(advance deposit)of more that ore-third of the total contract price of the total amount of all deposits or payments which the contractor must make,in advance,to order andfor otherwise obtain delivery of special order materials and equipment,whirl ever is greater Contractor: Kevin Murphy 98 Forest Street No.Andover, MA 01845 Registration No: 101874 l Section V-Acceptance 1 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 TH CONTRACT IF THERE ARE ANY BLANK SPACES Signature--J Date Signature Date i The Commonwealth of Massachusetts Department oflndustrialAceidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 wlvw.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Conti'actors/>llectricions/Plumbers. TO BE FILED WITH THE PkRNMITMG AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: w - City/State/Zip: tom/, i Phone#: µ Are you an employer?Check the appropriate bos: Type of project(required): I.W am a employer with I employees(full and/or part-time).* 7. ❑New construction 2,F-1 I am a sole proprietor or partnership and have no employees working for me in 8. emodeling any capacity.[No workers'comp.insurance required.] 9. Demolition I F1 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 0 Building addition 4. 1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other 152,§1(4),and we have no employees.[No workers'camp.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. tContractors that checkthis box mast 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 an employer tliat is providing warlret's'compensation insurance for'n:y employees. Below is the policy and job site information. Insurance Company Name: r. Policy#or Self-ins.Lic.#: ( f Expiration Date: L L P Job Site Address: �J - City/State/Zip; 6&&1 49 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required underMGL c. 152,§25A is a criminal violation punishable by a fine tip 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 hereby certify under the pains and penalties o petymy that the information provided above is true and co weet. 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#: AC CERTIFICATE OF LIABILITY INSURANCE 6/25/2014 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 CONTACT Sands Munroe NAME: M P ROBERTS INS AGCY INC PHONE . (978) 683-8073 ac Ne:(978) 683-3147 1060 Osgood Street E-MAIL sancli Ldmprobertsinsurance.com North Andover, MA 01845 INSURERS AFFORDING COVERAGE NAIC# INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURER,: GUARD INSURANCE '.... 169 BOXEORD STREET INSURE c: NORTH ANDOVER, MA 01845 INSURER D: INSURER E: INSURER F, EE COVERAGES CERTIFICATE NUMBER: 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 BYPAID CLAIMS. ILTR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMffS NSD WVD POLICYNUMBER MMA)d MMA)D' X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 ,000 ,000 '.. CLAIMS-MADE ®OCCUR PREMISES Ea occurm ce $ 500 ,000 ''... BOPI068945 11/22/13 1/22/1- pt`E XP one JUR $ 15,000ED A PERSONAL&ADVINJURY $ INCLUDED '... GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY E]PRO- ®LOC PRODUCTS-COMP/OP AGG $ 2,000 ,000 OT ER� $ AUTOMOBILE LIABILITY COOMBINEDDtSINGLE LIMIT $ 1 7U-070,OO BODILY INJURY(Per person) $ ANYAUTO MCA7013608 01/23/14 1/23/15 AS X 71 SCHEDULED BODILY INJURY(Per accident) $ A AUTOS AUTOS '. NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Pera "dent $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS UAB CLAIMSMADE AGGREGATE $ 1 r O OUT=O cUP9145304 11/22/1311/22/14 DED ErENTION $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY SEATUOERH ANY PROPRIETOR/PARTNER/EXECUTIVE Y N X TE 500,000 B OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCiDENi $ (Mandatory In NH) KEWC527844 07/01/14 7/01/15 E.L.DISEASE-EA EMPLOYEE $ 0 —10=0 Ifyes,descrbeunder 500 000 D S I ION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT3 r DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Addtienal Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION 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 01.845 ACCORDANCE WITH TIE POLICY PROVISIONS. '...., AUTHORIZED REPRESENTATIVE ©1988 2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014!01) The ACORD name and logo are registered marks of ACORD �y Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-053099 KEVIN W MURPI}Y 98 FOREST ST North Andover NSA 0�1� 92, Expiration Commissioner 06/29/2015 &Ze Office of Consumer Affairs&Busifiess Regulation OMEIMPROVEMENT CONTRACTOR 9,' ,egistration: 101874 Type: piraton. -6/29/2016 Individual KEVIN MURPHY Kevin Murphy 98 FOREST ST. 4 N.ANDOVER,MA 01845 Undersecretary i