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Building Permit # 6/4/2015
.................................... %%oRT11 BUILDING PERMIT 16 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received Date Issued: I6 IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no 0 MAP PARCEL: ZONING DISTRICT: Historic District yes no no Machine Shop Village yes,L, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building , `One family 11 Addition [I Two or more family 11 Industrial ,15�-Alteration No. of units: El Commercial 11 Repair, replacement [I Assessory Bldg El Others: El Demolition El Other DESCRIPTION OF WORK TO BE PERFORMED: /021X00fL- IV' AJ V Nom:,C-5- Identification- Please Type or Print Clearly ' _S J> OWNER: Name: elL, Phone: Address:-Z- 3Al:y'%L 0 er,S7Z= Contractor Name. 65 � Phone: -1 Email: / .rVu dee /," , Address: �, Z A4/4- 016"I` Supervisor's Construction License: (--'.S 10,5�e� —Exp. Date: /,:�/, ,—Oz Zf Home Improvement License: 16 3-2562 Exp. Date: L-'/Z 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: $-2"�-Z- G Check No.: 11 Receipt No.: '2 NOTE: Persons contracting with unregistered co tractors do not have access to he guaranty fund R N NO F ttORT H UW11 `' 11clover ® ® 1A LAKE h ,� ver, ass, CoCKICKL'WICK y1. ®ADRATE D PP5 U BOARD OF HEALTH In Food/Kitchen PE �RMIT T Lj Septic System THIS CERTIFIES THAT ....... .. c ..........C. o . . ............................................................ BUILDING INSPECTOR has permission to erect buildings on . ....... .... .... .. ,?Q, Foundation Rough to be occupied as ....... .. .t... ........... .. .... ..®.................................................................. 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 MONTHWO ELECTRICAL INSPECTOR UNLESS TI T Rough Service ........... ...... .. .... .................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Reguired 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. TMK Remodeling 214 Sutton Hill Rd Contract CSL 105086 North Andover MA 01845 Ensdorf 23 Appledore_Kitchen_R2 HIC 165887 978 852-4491 RRP LR000106 www.tmkremodeling.com CONTRACTOR AGREEMENT THIS AGREEMENT made this rAag�c 0- 20LY-by and between Theodore Kelley dba TMK Remodeling, Construction Supervisor License# 105086, 214 Sutton Hill Rd, North Andover MA 01845 hereinafter called the Contractor, and Gail Ensdorf hereinafter called the Owner. WITNESSETH, that the Contractor and the Owner for the consideration named herein agree as follows: ARTICLE 1. SCOPE OF THE WORK The Contractor shall perform all of the work described in the specifications entitled Exhibit A—Statement of Work, as annexed hereto as it pertains to work to be performed on property located at 23 Appledore St North Andover MA 01845. ARTICLE 2. TIME OF COMPLETION The work to be performed under this Contract shall be commenced on or before Ma , 2015 and shall be substantially completed on or before 2015 l6l ARTICLE 3. THE CONTRACT PRICE The owner shall pay the Contractor for the labor and materials to be performed and supplied under the Contract the estimated sum of Twenty Thousand Nine Hundred Seventy Two Dollars and No Cents ($20,972.00), subject to additions and deductions pursuant to authorized change orders. The contract price includes two components; Fixed cost of Thirteen Thousand Forty Two Dollars and No Cents($13,042.00) for the building materials and construction labor as specified in Exhibits A and B. Variable cost of Seven Thousand Nine Hundred Thirty Dollars and No Cents($7,930.00)for the allowance items listed in Exhibit 8 Allowances Schedule and will be 110%of the actual invoice price paid by the Contractor to his suppliers. Exhibit 8 lists the allowance items and budget costs the Contractor will purchase for the Owner. Sales tax and freight are not inlcuded in allowance budget. Contractor will furnish and install all building materials, fixtures and finish items unless noted otherwise. Items supplied by Owners: rtops_ WL4U'f_;' ` Rk 174 C 5j e-� crctit`v �� Ka(✓ `� S l! <wYsLt fE ARTICLE 4. PROGRESS PAYMENTS Payments of the Contract price shall be paid in the following manner from the Owner to the Contractor: 33% upon contract acceptance and signature; $6,990.67 33% upon rough building inspection;$6,990.67 33% upon final building inspection and owner sign-off; ($939.33) plus the actual contract price for allowance items as defined in Article 3. The contract cost for mutually agreed to change orders will be paid 50%at time of change order signature and 50% after completion and owner sign-off. ARTICLE 5. GENERAL PROVISIONS 1. All work shall be completed in a workmanship like manner and in compliance with all building codes and other applicable laws. 2. To the extent required by law all work shall be performed by individuals duly licensed and authorized by law to perform said work. 3. Contractor may at its discretion engage subcontractors to perform work hereunder, provided Contractor shall fully pay said subcontractor and in all instances remain responsible for the proper completion of this Contract. Copyright TMK Remodeling 2014 Initials All Rights Reserved Page 1 )1X014 TMK Remodeling 214 Sutton Hill Rd Contract CSL 105086 North Andover MA 01845 Ensdorf 23 Appledore_Kitchen_R2 HIC 165887 978 852-4491 RRP LR000106 www.tmkremodeling.com 4. Contractor shall furnish Owner appropriate releases or waivers of lien for all work performed or materials provided at the time the next periodic payment shall be due. 5. All change orders shall be in writing and signed by both Owner and Contractor. The cost for mutually agreed to additional work, required due to unknown conditions or substantive change orders, will based on the current bill rates for the actual time used.Additional materials will be billed at contractor cost.All change orders subject to 10% markup for overhead. 6. Contractor warrants it is adequately insured for injury to its employees and others incurring loss or injury as a result of the acts of Contractor or its employees and subcontractors. 7. Contractor shall at its own expense obtain all permits necessary for the work to be performed. 8. Contractor agrees to place all debris in an on-site trash receptacle(dumpster)and leave the premises in broom clean condition. 9. In the event Owner shall fail to pay any periodic or installment payment due hereunder, Contractor may cease work without breach pending payment or resolution of any dispute. 10. The Contractor and the Owner hereby mutually agree in advance that in the event that the Contractor and Owner have a dispute concerning this contract, the Contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the Contractor and Owner sh II be required to submit to such arbitration as provided in MGL c 142A. OwnDate I-lk 1�/ � 4 C ntractor Date 12. Contractor warrants all work for a period of 12 months following completion. 13. Contractor may post small signage (18x24") on property advertising services during the duration of the project. 14. The Contractor and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Office of Consumer Affairs and Business Regulation Ten Park Plaza, Suite 5170 Boston, MA 02116 Phone: (617) 973-8700 �� Copyright TMK Remodeling 2014 Initials j+& All Rights Reserved Page 2 3/3v/ r TMK Remodeling 214 Sutton Hill Rd Contract CSL 105086 North Andover MA 01845 Ensdorf 23 Appledore_Kitchen_R2 HIC 165887 978 852-4491 RRP LR000106 www.tmkremodeling.com 15. The Contractor or Owner may terminate this contract at any time for any reason by giving 3 days notice in writing to the other party. If the Owner terminates the contract as provided herein, the contractor will be paid a fair payment for work (labor and materials)completed as of the date of termination plus any materials or equipment that are backordered and not delivered. Fair payment is defined as actual job costs for the project plus 10% overhead charge. The contractor will provide a written report detailing actual job costs plus overhead for payment. If the Contractor terminates the contract as provided herein, then the Contractor will refund any funds paid by the Owner that are a remaining balance for the labor and materials used as of the date of termination plus any materials or equipment that are backordered and not delivered. The Contractor will make arrangements for the backordered items to be delivered to the Owner. ARTICLE 6. OTHER TERMS ARTICLE 7.ACCEPTANCE 1 i Signed this day of 120 Owner C tr ctor ' NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Copyright TMK Remodeling 2014 Initials All Rights Reserved Page 3 Licenses: TMK Remodeling Exhibit A-Statement of Work CSL 105086 214 Sutton Hill Rd Ensdorf_23_Appledore_Kitchen R2 HIC 165887 North Andover MA 01845 RRP LR000106 978 852_4491 www.tmkremodeling.com A B C D I E F G I 1 Owner: 2 Gail Ensdorf 3 geensdorf amail.com 4 23 Appledore St 5 North Andover MA 01845 6 Estimate: 2015-001.2 Estimate valid for 30 days 7 Estimate Date: 03/03/15 Expiration Date: 04/02/15 8 Scope of Work First floor kitchen remodel approx.190 SF in existing footprint and new configuration for fridge area.Remove 5 appliances and sink,3 cabinets and fascia,wall and ceiling finishes(partial).Remove countertops.Fit out electrical for new appliance locations and upgrade circuits for code compliance.Install new cabinets and appliances. Patch wall and ceiling finishes.Install new countertops.Remove 9 wall paper.Paint walls and ceiling. 10 Notes: 11 This is an estimate only,not a contract.This estimate is for completing the job described in the statement of work,based on our evaluation. 12 It does not include unforeseen price increases or additional labor and materials which may be required for unknown conditions. 13 Pricing includes labor and materials to install finished item+allowances. EA=Each LF=Lineal Feet SF=Square Feet 14 EA LF SF Total Cost 15 Quanta CosityGost Quanta Cost 16 1.0 Administration 28 $2 015 $2,015 17 01 Plans and Permits:01.2 Building Permits 3 $380 $380 18 Building Permit 1 $240 $240 19 Electrical Permit 1 $85 $85 20 Plumbing Permit 1 $55 $55 21 02 Site Work 25 $1,635 $1,635 22 20 Yd Dumpster 1 $495 $495 23 Adjacent spaces to be protected by temporary barriers from dust infiltration 1 $120 $120 24 All debris to be placed in dumpster and premises left in broom clean condition on daily basis 20 $770 $770 25 All floor coverings and hand rails between the work area and primary entrance to be covered with protective covering material 1 $155 $155 26 Owner responsible for storing any items to re-installed 1 $0 $0 27 Work area to be vented during demolition and construction to minimize dust infiltration 1 $95 $95 28 KitchenlQirur q--190 SF 40 $8,520 8 $373 1357_$8,159 $17,051 29 02 Site Work:02.10 Demo 8 $309 560 $840 $1,149 30 Disconnect and dispose of appliance 5, $238 $238 31 Disconnect and dispose of solid surface counter top 56 $84 $84 32 Disconnect and remove wall cabinet 3 $71 $71 33 Remove wall paper on walls 440 $660 $660 34 Remove wall/ceiling(partial)finishes to expose framing. 64 $96 $96 35 14 Plumbing 3 $743 $743 36 Install 3/4 HP garbage disposal+allowance 1 $283 $283 37 Install Dishwasher 1 $230 $230 38 Install kitchen_sink&faucet +fixture allowance 1 $230 $230 39 15 HVAC 1 $175 $175 40 Install 12x6"HVAC register through cabinet fascia 1 $175 $175 41 116 Electrical&Lighting 21 $3,625 $3,625 42 1 Furnish and install 6°recessed fixture on new switch 5 $850 $850 43 Furnish and install counter outlets for code compliance. 6 $450 $450 44 Furnish and install power forthe following appliances:dishwasher,refrigerator,disposal,electric stove,vent hood. 5 $850 $850 45 Install appliance on circuit as specified by manufacturer 5 $1,475 $1,475 46 18 Interior Walls 8 $373 $373 47 1 side wall finish:1/2"plasterbase,plaster skim coat,3 coats paint,wood baseboard 8 $373 $373 48 19 Ceilings&Cover 32 $183 $183 Copyright©TMK Remodeling All Rights Reserved Page 4 Unlawful to distribute without permission Licenses: TMK Remodeling Exhibit A-Statement of Work CSL 105086 214 Sutton Hill Rd Ensdorf_23 Appledore Kitchen_R2 HIC 165887 North Andover MA 01845 RRP LR000106 978 852-4491 www.tmkremodeling.com A B I C D E F G 1 49 Ceiling-112"plasterbase,plaster skim,2 coats paint on 1x2 strapping 32 $183 $183 50 21 Cabinets&Vanities 3 $218 4 $300 $518 51 Install vanity/cabinet 3 $218 $218 52 Supervise template and installation of countertops 4 $300 $300 53 22 Specialty 35 $466 $466 54 Wall Backsplash+the allowance 35 $466 $466 55 24 Paint 630 $1,890 $1,890 56 Prime(1 coat)and Paint(2 coats)walls/ceilings/trim 630 $1,890 $1,890 57 32 Allowances 4 $3,450 96 $4,480 $7,930 58 Design fabricate and install custom made cabinets to match existing 3 $3,000 $3,000 59 Sink&soap dispenser 1 $450 $450 60 Template,fabricate and install solid surface countertops 56 $4,200 $4,200 61 Tile for backsplash 40 $280 $280 62 Overhead 1 $1,906 $1,906 63 31 Overhead&Expenses 1 $1,906 $1,906 64 Overhead and project administration1 $1906 _ $_1,906 65 Grand Total 69 $12,441 8 $373 1357 $8,159 $20,972 Copyright©TMK Remodeling All Rights Reserved Page 5 Unlawful to distribute without permission Licenses: TMK Remodeling Exhibit B-Allowance Schedule CSL 105086 214 Sutton Hill Rd Ensdorf 23_Appledore_Kitchen_R2 HIC 165887 North Andover MA 01845 RRP LR000106 978 852-4491 www.tmkremodeling.com Owner: Gail Ensdorf gensdorf@gmail.com 23 Appledore St North Andover MA 01845 Category" _, W 32 Allowances Cost Column Labels Row Labels EA SF ` Grand Total Tile for backsplash 280 280 Template, fabricate and install solid surface countertops 4200 4200 Design fabricate and install custom made cabinets to match existing 3000 3000 Sink&soap dispenser 450 450 Grand Total 3450 4480 7930 Copyright @ TMK Remodeling All Rights Reserved Page 6 Unlawful to distribute without permission The Commonwealth of Massachusetts Department of Industrial Accidents d I Congress Street,Suite 100 Boston,MA 02114-2017 .` www.mass.gov/dia 5�•v Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNHTTING AUTHORITY. Applicant Information Please Print Letlibly Name(Business/Organization/Individual): IRS 444 Address: 7 �c�� !� � � All�c��� �(� City/State/Zip: Phone Are you an employer?Check the appropriate box: Type of project(required): am a employer with 4 employees(full and/or part-time).* 7. ❑New construction I am a sole proprietor or partnership and have no employees working for me in 8. RemOdelirig any capacity.[No workers'comp.insurance required.] 9• ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 Q Building addition 4.❑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.Q 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.$ 14.❑Other, 6.Q We are a corporation and its officers have exercised their right of'exemption per MGL c. 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. 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 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site irrfornration. Insurance Company Name: Exp irationDate: Policy#or Self-ins.Lie.#: Job Site Address: 3 /4��'L`[ City/State/Zip: M- AXN !V v"I C��rJ ItA'f 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 hereby certify er•the ains andpenalties ofperj y t he information provided above is true and correct. Date: signature: Phone#:------------------------ v 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#: OP ID:J CERTIFICATE OF LIABILITY INSU NCE bATE(MNUDD/YYYY) 05/14/15 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 R 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 ' 978-975-1300 NAME CT Segreve&Hall Insur.A40c-InC979.975_7598 PHONE FAX 305 North Main St. a/c No exi: aC No 1 Andover,MA 01810 i AoofiEss: Lawrence J.Hall �RovucER D e:TMKRE-1 i INSURER(S) AFFORDING COVERAGE NAIL N INSURED TMK Remodeling INSURER A.Arbella Protection Ins.Co. 41360 214 Sutton Hill Rd INSURERS;AEIC 11104 North Andover, MA 01845 INSURER C i INSURER D I INSUUA E IN F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY TWAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHOTANDING 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 CONIPITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR TYPE OF INSURANCEINSR EJ POLICY NUM@ER DD/Y FF MM%I OY LIMITS GENERAL LIABILITY EACH OCCIA URRENCE g 1,000,00 I A X COMMERCIAL GENIiRAL LIABILITY PREMISES Ea oCcurmnqel 100,00 CLAIMS-MADE I F—I OCCUR MED EXP fA one perEon) $ 5,00 i 9520037133 03/06/15 03/08/16 PERSONAL&ADV INJURY s 1,000,00 , GENERAL AGGREGATE S 2,600,00 GEN'L AGGREGATE LIMIT APPL)ES PER: PRODUCTS-COMPIOPAGG $ 2,000,00 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea�cgdent) ANY AUTO I BODILY INJURY(Per person) S ALL OWNED AUTOSI BODILY INJURY(Per accident) $ SCHEDULED Aurod PROPERTY DAMAGE HIRED AUTOS (Per accident) S NON-OWNED AUTO$ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAINIS-MADE AGGREGATE $ DEDUCTIBLE RETENTI N $ WORKBRS CO1APEN8ATI6N I WC STATIJ OTH- AND EMPLOYERS'LIABILITY Y I N _TORY ER 13 ANY PROPRIETOR/PARTNER/P.XECUTIVE OFFICERWEMBEREXCLUOED? L] NIA E.LEACH ACCIDENT $ (Mandatory In NH) 5005011872 04/01/15 04101/16 E.L.DISEASE'FLA EMPLOYEE $ Ify e9,descrihounder DES RIPTION OF OPERATIONS below E.L.DISFASE-POLICY LIMIT $ t DESCRIPTION OF OPERATIONS)LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more sp2kco Is required) I I I CERTIFICATE HOLDEN CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of N+rth Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Building Inspector Bldg 20 16000s St Suite 205 AUTHORIRIZ�EDDRRE�P(R_ES�ENTATIVE Norther Andover,MA 01845 I i ®1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) 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-105086 : THEODORE M KELLEY 214 SUTTON BE1,RD NORTH ANDOVtR MA"61945 J Expiration Commissioner 10/08/2015 �� ��e tpoaxo�zaauaecclf�a�C-/l��caaac�cceeCZJ Mee of Consumer Affairs&Business Regulation �ME IMPROVEMENT CONTRACTOR gistration: 165887 Type: xpiration: ''4/5!2016 DBA TMK REMODELING THEODORE KELLEY 214 SUTTON HILL RD. g NORTHANDOVER, MA 01845 Undersecretary License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Not valid without signature