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HomeMy WebLinkAboutBuilding Permit # 5/6/2015 t%ORTH BUILDING PERMIT TOWN OF NORTH ' .r - 60 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received 'o1 -1.1� Nv pss cHus Date Issued: � � g IMPORTANT:Applicant must complete all items on this page r ✓/ er, ,./,,�r; � i, /�//,..�%�rr%//�i�.���i�/l/�/���.,,,//�rii/,///r�.r////I/�f /// //r !.✓,; / r � / / / r r ri r r, r. r r ✓.. , /� Ar////r�P L, i� ,�r�//,�ZC7N NG DISTRICT/./Jo/ //ri Misto is D�strtct i , r r. J , � / r ��/, r,/,r„i // r/,�,/ ✓, a, _,oil/. �,/,���,,,�.��j/rl///,/�/r�/��///���j//%///„�>%///��r/,,,/irr�//l, �i�i„r//gin r�,,,,, r.✓„i,,,,,,,, ,r, ,,,, „z; ,,,,,,,,a,,,,,,,, „`J', o,y,;,; / , p ;>, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building WOne family ❑Addition ❑ Two or more family ❑ Industrial Qf Iteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Se %❑Well El Floodplain ,❑Wetlands ❑ Watershed District "'P,irrr/% / /r: / Wate Sewer r r / %i/ ,,,,////�„�„ r/vsrr�,%/rG�,",,, rrI✓�i, r„<rii„/ 1�s/,/,<,�,,,;i ,,,�/ii Gi,/ivi,,:�%�%/„<r//�r//// ,r�/ri,,, ,/i„• : DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: in- W ° R� ,, Address: / ', 'd / r Contrasfor Name //% ,� // Phoney/ ;rye / , ' r i r r /r r r / r o / r i Il //. / ✓ / rc ,,,.,. rrrr / r r �. �/i ,. / r /.. r•. ,i.. ,,, / �/ .../. % //, ,.,,// / / ✓< /.�/i/ /. .//, /, // :..r„/. ii ,..// // // r., rrr i ,,,,, ri /ter✓///.. r..r r ,../. ,///r / r.... / /.. / i ,; ✓r „r//rod ..G/„�/ .,/,�//r/r, r /,,,,,.i- ,,/�i�//,.,;r,, /r/ �. // rr.. rr, // /,,,iii�✓/i i//� / „i:... ,,,... ;// r%r rr ;, r/ r,,//r /1�// /�> J��/,.. f�/�//Nwr/�/,/l, „,,.,, ,/G �/.,,//// ,,,,i. r,4 rr,�, ,c ,, „ /i/;G,,.r,.. o,w///i , G✓�;. ,,,�/i/%�O/,,,,,� ,r ///� / r, r r/ i /i r / cr r,, r / rr ,a�//i i ✓ / ! ry ,.. ria / i. /r . �. :////�,/!/�.:/// ,.rrr��. �, ///�i///i/•/%./�,///�/✓ r / /c, /,/,, or,,,- Su `e, S�/�Jil.r S (�o / /, rI �,,, � ✓ / i��� ///r // /r p� l6 11// l !r /, _rl � , a,•c,,,r/,i aU// �/r /,/ < x . r Ra�rril ,/,r''/ri/r,,,,,, • / / / r /,r ,o/ / / r /,/ ri rr rrir- ✓rrrr- ,r r, ,„J/rr/�/�./,r,r%//..,,. ✓r r,...,�,r�/�../� r. ,.,,r,,, ,- ,/ r,Y ,,r, �r ./. / / .✓ ,e � / rc. i..,.r , / :f/s / � .r ',✓ /ri// / ,,,,;/ /' ////G///, /l /, -„r 1�-,r,.! i%r, �/r„r o,,,,:; Ho e Im ..:.roue ent License,� ,,;,< , r,' ,,, ,�„ ��� /�l�/�i, r r r„r„ ,• //r � ,/, �i 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: $ FEE: $ O Check No.: i )--11 1 Receipt No.: NOTE: Persons contracting with 1r, ' tered contractors do not have ac ess to the guaranty fund Signature of Agent/OwneU)"ig,nature- of contracto r I Uwn 0'h' I '� _E1-% dx--&verI U ® ' ® _ �® LAKE h y ver, ass, 1� IL COC 111C»EWIC. y1. 4ArED P4�,`�C`' BOARD OF HEALTH Mr Im rhRMI �T ]�F� %o 'Lu Food/Kitchen Septic System THIS CERTIFIES THAT �� /���� BUILDING INSPECTOR ...... :�... ....................................................................................................... has permission to erect buildings on 1� 7.2" .. Foundation Rough c ` to be occupied as {� ......�! 6s ..................1.. ................................................................................................ 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 THS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough ��-- Service ................. ...... .. ...................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy 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 Approved by the Building Inspector. Burner Street No. Smoke Det. 98 Forest Street Kevin I. � ® North Andover,MA 01845 • PH:978-688-5335 Building Contractor 0FAX:978-688-7207 Proposal To: Keith Mullen i 1327 Salem 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: 5/6/2015 Job: Replacement windows 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 4/27/15. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 5/20/15.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. i Section III-Scope of Work Page 1 of 4 Kevin Murpity Page 2 of 4 Buuilditig Contractor, g 98 Forest Street North Andover,MA 01845 PH:97&688-5335 FAX:97868&7207 General Proposal is to supply and install thirteen replacement windows. Permit will be obtained by contractor. Building Thirteen Harvey replacement windows will be supplied and installed Seven windows on first floor will be clad exterior, and clear pine interior. Six windows on second floor will be clad exterior and interior. New pvc window sills will be supplied and installed. No allowance has been made to replace any interior or exterior casing. First floor windows will have wood removable grilles. Second floor will have grilles between the glass. All windows will have full screens. Painting j No allowance has been made for any interior or exterior painting. Waste Removal i All construction debris will be disposed of by contractor. I f e'v "x MttrPage 4 of 4 BufldhigConlrartor 98 Forest street Nath Andover,MA 01845 PH:978888-5335 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... ... ...... ... ......... ... ... ... ....$ 8500 Payment to be made as follows: Percentage/Item Description Amount 1 Permit obtained / deposit $4000 2 Job complete $4500 Total 2 1 $8,500.00 "Notice:No agreement for Home improvement contrading work shall require a dorm payment(advance deposit)of more that ane-third of the total contract price of the total amount of all deposits or payments which the contractor must make,in advance,to order arKVor otherwise obtain delivery of spedal order materials and equipment,whictmer 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 / I I OT T IS CONTRACT IF THERE ARE ANY BLANK SPACES 1, Signature " � � ..,°'� Date I Signature Date The Commonwealth of Massachusetts .Department oflndustrialAccidents X Congress Street,Suite 100 Boston,MA 02114--2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILL,D WITH THE PE RINRTTING AUTHORITY. Annlicant Information Please Print Legibly Name (Business/Organizationlindividual): Address: City/State/Zip: ,, , 6 hone#: T Are you an employer?Check the appropriate box: Type of project(required): LtSj am a employerwith I _employees(full and/or part-time).* 7. 0 New construction 2.0 I am a sole proprietor or partnership and have no employees working for me in $. f6Remodeling any capacity.(No workers'comp.insurance required.] 3.0 I am a homeowner doing all work myself.[Mo workers'comp.insurance required.]t 9. ❑Demolition 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 0 Building addition 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? p 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.0 Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box 01 must also fill out We section below showing their workers'compensation policy information. I 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 ain an employer that is providing workers'compensation insurance for ruy employees. Below is thepolicy andjob site information. r el insurance Company Name: Policy#or Self-ins.Lic.#: l _ S ° Expiration Date: 5 Job Site Address: L 3 2,fl. 2,a'k City/State/Zip: c e 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 ptnlishable 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 Iter by certify tinder the pains andpenattlesAfpaymy that the information provided above is true and correct. Sienattue: Date: Phone#: Official use only. Do not rprite in this area,to be completed by city or toren official. City or Town: Permit/License# Issuing Authority(circle one): i 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Rlectrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: )IY lote9RHi.sGRTIFIt+/`11 L'f'l�ILl e 1 'IYrr7VItM1�9vE 6/25/014 won 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 conferrights to the certificate holder in lieu of such endorsement(s). PRODUCER FNAME7 Sandi Munroe M P ROBERTS INS AGCY INC (978)683-8073 ac o:(978) 683-3147 1060 Osgood Street DRESS:San mprobertsinsurance.com North Andover, MA 01845 INSURERS AFFORDING COVERAGE NAIC# INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURER,: GUARD INSURANCE 169 BOXFORD STREET INSURERC: NORTH ANDOVER, MA 01845 INSURER D: INSURER E: INSURER F, 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 PER10D INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSLED 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. ILTR TYPE OF INSURANCE IVSD NNU POLICY NUMBER PMO/ID1Y EFF aPrOQ1�Y EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 ,000 ,000 Imr- CLAIMS-MADE 117-71 OCCUR PREMISES Ea occurrence $ 500 ,000 BOPI068945 11/22/1311/22/14 MED EXP one erson $ 15,0100 A I PERSONAL$ADVINJURY $ INCLUDED GEN'LAGGREGATE UMITAPPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY®JERI CT ®LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER� $ AUTOMOBILE LIABILITY CINdEPDISINGLEUMIT $ 1,000,007 ANYAUTO BODILY INJURY(Per person) $ A A TOS NED X SCHEDULED MCA7013608 01/23/14 1/23/15 AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Pera 'dent A ::JUMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000 IXCEssLAB CLAIMS-MADE CUP9145304 11/22/1311/22/14 AGGREGATE $ 1,505,055 DED RETENTION WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE, ER ANY PROPRIETORIPARTNERIDCECUTNE 500,000 B OFFICERIMEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ (MandatoryinNH) KEWC527844 07/01/14 7/01/155' E.L.DISEASE-EA EMPLOYEE $ ,O O Ifyes,descrbeunder 500 OOO DESCRIPTION OF OPERATIONS be v DISEASE- LIMIT $ l DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached ifmore space's required) CERTIFICATE HOLDER CANCEL TION 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 ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE YK ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-053099 KEVIN W MURPOi' :.. 98 FOREST ST E North Andover> 92, �� Expiration Commissioner n�e'rr 06/29/2015 i ��e�pavr�na�acuealC�i���P/f�ccvJ«c�uaelt i Office of Consumer Affairs&Busihess Regulation OME IMPROVEMENT CONTRACTOR egistration: 401874 Type: j .7 xpiration: -6/29/2016 Individual KEVIN MURPHY Kevin Murphy 98 FOREST ST. g y _ N.ANDOVER,MA 01845 Undersecretary