HomeMy WebLinkAboutBuilding Permit # 6/18/2015 UILUI U VtKMI I
TO TANDOVER � n �
APPLICATION FOR PLAN EXAMINATION
r
Permit NO: Date Received
�9 °SATED
Date lssued:16116'.' S CHUS
I ORTANT:Applicant must com Tete all items on this a e
- a
LOCATION
PROPERTY OWNER 1 f,i� (Print O I
Print
MRP NO: PARCEL: ZONING DISTRICT: Historic District yesC, r
a
Machine Shop Village yes
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building P4 One family
❑Addition ❑ Two or more family ❑ Industrial
Iteration No. of units: ❑ Commercial
Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
11 Septic ❑ Well ❑ Floodplain ❑Wetlands ❑ Watershed District
W Water/Sewer
N . ee(1k'1(.4L1 &Sill 6 W16106 c'K;h 0r, L dor" VA'n
Identification +Please Type or Print Clearly)
OWNER: Name: 1 f �"V�l(f �. °r } � PhJone: -'
Address: _
CONTRACTOR Name: Phone:
Address:
Supervisor's Construction License: Exp. Date.-
Home
ate:Home Improvement'License: Exp. Date:
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE.BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
� �°' FEE: $
Check No.:
Total Project Cost: �° a, _.
Receipt No.: A C
NOTE: Persons contras n 'lith unregistered contractors do not have access tot e guaranty f,,rid
Spf/ nt/Owner �h Signature of contractor
Signature
F t%ORTHAh
A"I%k WIE&Ift A-1b,T _V " X T d-U-mls/qL nclu V V11 U V V 11 U1
2 _ ;� a ;..,,, ,
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No. t
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" h ver' Mass 00
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COC NIC Nl W,CN
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BOARD OF HEALTH
Food/Kitchen
PER T LD Septic System
THIS CERTIFIES THAT ........ ` BUILDING INSPECTOR
..... ....... ......... �h. ..................... ............... ..........
Foundation
has permission to erect .......................... buildings on ... ...... ...... .... .. . .... ....
Rough
tobe occupied as ...vkr..®.......ls . .. . ...... .......................................................................... 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 MO H ELECTRICAL INSPECTOR
LESS CO STR 10 ST Rough
Service
........... .. ............... ..................................... Final
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Reguired t® Occupy Buildin¢ Rough
Islay in a Conspicuous Place on the Premises — Do Not Remove Final
Yd
No Lathing or Dry all To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
TO"OF NORM AND OVER
�u9-i O��CCE�!OF
DY x:1-4 TWNT r
Nr
:1600'QsgoDRSteofBuff diug20,-Svzte,236
`� p��'�77lA F4�,4•[5 ' • •�$� Xbith A,r,.clovorg Massachusetfa 0184;5 1iCi-lt�s��
Gerald A.Brown TWOPILcue,(979)5889145
1nspeeforOfJ311dings day, (978)689-9542
-HQME6WNBRMCENSE EYEYPTJON .
PFIPMT"PLICATION
Mono prm '
DATE.
BOB LOCAT. ON;
Number �izeet A ddres �Vlap/Zot '
�7'ame. . �1.ozne one •l�oxl�I'hane '
IM-SENT MAU!hqG ADDPXSS --52
cy s 7 -
. �'p Co.rhe
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The current e emnfion dor"homeowners"was extended to?�clude owner o cctipied dwellings to t4vo units-qr€ess ant
fa allow 5u�bh home-mmexs to engage an?�idi�lam1al.fox dire-WAO does notPossess a licmim,pxovlded that Me,owner
acts as slxpazv?sor). ,iate33i(divg (Code usotiol7 Zp8.3,5.7)
DES ITION OYHOMEOW.b P, ,
persons)who awns aparcel ot'larrd on which&elshe resides or intends to reside, on wh%ch there is,ox is infended to
-,a one or two f'ar gilt'struefums. A.p erson ko camtru cts more that one homD iu.a two-yearpezzo d shall ztot be
considered alzomeowner,
The 2mclaxsxgnod"humadwzrer" mpliances With the StatOBuzf&ag Code anti other
Applicable codes,"by laws,tales and-Xegulatlow,
The undersigned"Tiomeownex"'cextr des that tTie Tovrn Of North Amdov'erRanding De&zfzaeut
xnspeotion procedures and requirements and that:hQIShE will GompZyW h,sand pxoeecTures autT
xequireznerrts,
HONMOWMERS 90MATM
A' ROVAL OF BMDWG OFFICIAL
Reyis d 9.2809
FozznS�omeawnersl'sx8mp[ion '
3DARD OFApp.EA7 -688-9.541 CbhrSFR'4MON 689-9530 MALTH 688-9540 PL-MMG 688153:5
The Commonwealth of Massachusetts
0 Department of IndiustrialAccidents
~: 1 Congress Street, Suite 100
Boston,MA.02114-2017
�r www.mass.gov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbexs.
TO BE FILED WITH THE PERMCT f1NG AUTAORTTY. Please Paint Legibly
A '•licant Information
Name (Business/Organization/Individual)` !moo
Address: ,J!yo�l�i r2� R)a"`
/y /�7 �✓e. /M `� Phone#: ®` `� 7
City/State/Zip: :.:.
..° Type of project(required):
Areyou an employer?Checktlie appropriate box:
eto ees full and/or part time).* 7. []Nev;�'c6nstructlon
1.Q 1 am a employer with m P Y
2.F11 am a sole proprietor or partnership and have no employees
Y capacity. Working for mein $,��s7��Remodeling
an acity.[No workers'comp.insurance required.] 9, j Demolition
3.❑1 am a homeowner doing all work myself[No workers'comp.insurance required.]t 10❑Building addition
401 am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ❑Electrical repaij:s or additions
ensure that all contractors either have workers'compensation insurance or are sole '11 bin repairs Or additions
proprietors with no employees. 12;��Plumbing p
5.❑1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 13• Ro6f regi airs
These sub-contractors have employees and have workers'comp.insurance.t 14.0 Other
6.❑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 A 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 check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities,have
employees. 1f the sub-contractors have employees,they must provide their workers'comp.policy number.ce for my employees. Below is the policy and job site
-
lam an employerthat is providingworlcers'compensation insuran
information.
Insurance Company Name:
Expiration Date,
Policy#or Self-ins.Lic.#:
City/State/Zip:
Job Site Address:
compensation policy declaration page(showing the policy number and expiration date
Attach a copy of the workers'
by a ffilb-up to$1,500-00
Failure to secure coverage as requited under MGL c. 152,§25 oxm of a STOPcriminal1WOIRK ORDER olon and a e of up to $250.00 a
and/or one-year imprisonment,as well as civil penalties in the f
may be forwarded to the Office of Investigations of the DIA for insurance
day against the violator.A copy of this statement
coverage verification.
X do hereby cec paz arldpenalties ofperjury that the informationpiovidedabove is true and correct.
Date: "s>
Si
Si ature: i
<_
Phone#:
o - 2F3
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): i
1.Board of Ifealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Phone#•
Contact Person:
9 �
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X1
S-�`N C-,::> Ci�sr��
6 j-7 Yr
96
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0
Claims Processing - Arnica Scan Center Toll Free: 1-877-75-AMICA
PO Box 9690 (1-877-752-6422)
Providence, RI 02940-9690 Fax: 1-866-934-5962
AUTO HOME LIFE
April 10, 2015
Ms Michelle A Rotter
Mr Bryan Bendig
59 Berrington PI
North Andover,MA 01845-2152
Pile Number: 60002095405
Date of Loss: 03/17/2015
Deductible: $2,500.00
Dear Ms. Rotter and Mr. Bendig:
ICA Independent Adjusters estimates that the repairs to your home will cost
$24,256.03 on a replacement cost basis. While your policy provides coverage for full
Replacement Cost Value (RCV) of the damage to your home, it also states that we will
pay no more than the Actual Cash Value (ACV) of the damage until actual repair or
replacement has been completed.
Our payment of$18,902.11 reflects the ACV of your home's damages less your
deductible. We have withheld $2,853.92 in depreciation. We will make an additional
payment to you for the RCV of the repairs, up to the amount of withheld depreciation,
once we receive documentation confirming the actual cost you incurred to have the
repairs completed. We will not pay more than the actual repair cost.
Please call me with any questions.
Sincerely,
6�6�1 ��
Kylie J. Wojahn AIC, AINS
Arnica Mutual Insurance Company
877-752-6422 x21765
KWOJAHN@AMICA.COM
-1- nC%A4DAXTV ANrT('A PROPr,RTY AND CASUALTY INSURANCE COMPANY
Insurance Claims Adjusters.Inc.
CA ,Inc. 11405 North Community House Road Suite 400
Charlotte,NC 28277
1-877-807-9669 Voice
1-877-807-9670 Fax
Home: 860-561-9672
Insured: Bendig,Bryan Cell: 860-490-9963
props: 59 Berrington PI E-mail: madlaxbryan@gmail.com
North Andover,MA 01845-2152
Home: 59 B en ington PI
North Andover,MA 01845-2152
Business: 877-752-6422 x 21765
Claim Rep.: Duane Smith E-mail: duane457@aol.com
Business: 903-216-0089
Estimator: Duane Smith
E-mail: duane457@aol.com
Policy Number: 65042023CU
Type of Loss:Freeze
Claim Number: 60002095405
Price List: MAEM7X_APR15
Restoration/Service/Remodel
Estimate: BENDIG BRYAN
of observed damages for your personal property and/or the estimated cost of covered repairs to your
This is the estimated amount final review.Your policy may contain provisions that
aid for certain items.Your adjuster will explain any applicable coverage limitations to YOU.
home.This estimate is subject to Arnica Mutual Insurance
could limit or exclude the amount p
' ate is not a guarantee that coverage will be provided and is not intended to replace any of the terms and conditions m
This estimate
your policy.
reed figure for the covered repairs and/or
e If you or your contractor disagree with the extent or cost of repairs outlined in this
W e will work with you and your chosen contractor to attempt to reach an agreed
replacement of your personal property. y lease contact Arnica so we can provide further assistance.Please remember that
ered or
estimate,or if additional damage is discovered, to inspect any supplemental damage before the damaged items are rep
you are required to provide us with an opportunity
replaced. them of the loss and
Your Mortgagee may be included as an additional payee.We recommend You contact your lender to nod.
tify
discuss their specific requirements for endorsing checks.Please let ns know if we can help 1 eontathis ot ns so we can assist you.
If you have any questions about this estimate or any of the information presented here,pleas
i
Insurance Claims Adjusters.Inc.
Inc. 11405 North Community House Road Suite 400
Charlotte,NC 28277
-- 1-877-807-9669 Voice
1-877-807-9670 Fax
CONTINUED-Master Bath
DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV
17. Final cleaning-construction- 151.69 SF 0.20 0.00 6.06 36.40 (0.00) 36.40
Residential
Totals: Master Bath 16.39 233.20 1,399.20 98.92 1,300.28
ti
Closet 1 Height:9'6"459.00 SF Walls 164.25 SF Ceiling
623.25 SF Walls&Ceiling164.25 SF Floor
48.83LF Floor Perimeter
18.25 SY Flooring151.33 LF Ceil.Perimeter
:.---14'2"
2'6"X 61811 Opens into Exterior
Door , Opens into Exterior
Window 3 X 4 p
DESCRIPTION QUANTITY UNIT PRICE TAX O&P RCV DEPREC. ACV
18. Content Manipulation charge-per 1.00 HR 34.78 0.00 6.96 41.74 (0.00) 41.74
hour
19. R&R Batt insulation-6"-R19-paper 32.00 SF 1.24 1.24 8.18 49.10 (1.35) 47.75
faced
20. R&R Thin coat plaster over 1/2" 32.00 SF 4.66 1.46 30.14 180.72 (1.59) 179.13
gypsum core blueboard
1.00 EA 11.73 0.04 2.34 14.11 (0.47) 13.64
21. Mask and cover light fixture
22. Mask the floor per square foot-plastic 164.25 SF 0.20 0.51 6.68 40.04 (5.58) 34.46
and tape-4 mil
r 132.25 SF 0.52 0.08 13.78 82.63 (0.90) 81.73
23. Scrape part of the ceiling&prep fo
paint
24. Texture drywall-light hand texture 164.25 SF 0.49 0.72 16.24 97.44 (0.78) 96.66
25. Paint the walls and ceiling-two coats 623.25 SF 0.75 7.40 94.96 569.80 (80.53) 489.27
26. R&R Baseboard-3 1/4" 48.83 LF 3.07 3.36 30.66 183.93 (3.65) 180.28
27. Paint baseboard,oversized-two coats 48.83 LF 1.25 0.46 12.30 73.80 (4.99) 68.81
28. Sand,stain,and finish wood floor 164.25 SF 3.97 9.65 132.36 794.08 (157.50) 636.58
29. Final cleaning-construction- 164.25 SF 0.20 0.00 6.58 39.43 (0.00) 39.43
Residential
24.92 361.18 2,166.82 257.33 1,909.49
Totals: Closet 1
Total: SECOND LEVEL 41.31 594.38 3,566.02 356.25 3,209.77
4/8/2015 Page:3
BENDIG BRYAN
i
li
yp. Insurance Claims Adjusters.Inc.
!JrAj Inc. 11405 North Community House Road Suite 400
Charlotte,NC 28277
1-877-807-9669 Voice
--- 1-877-807-9670 Fax
Height:9'6"
x--23 8r Family Room
z 2 a N 823.63 SF Ceiling
T 991.98 SF Walls 823.63 SF Floor
�{ I 1815.61 SF Walls&Ceiling 117.40 LF Floor Perimeter
F a T` 91.51 SY Flooring
a N" 117.40 LF Ceil.Perimeter
1,--23'10 3�X 4, Opens into Exterior
Window 314"X 4' Opens into Exterior
Window 4'X 4' Opens into Exterior
Window 3'6"X 4' Opens into Exterior
Window 17,X 41 Opens into KITCHEN DIM
Window R� DEPREC. ACV
TAX O&P
DESCRIPTIONQUANITTY UNIT PRICE 41.74 (0.00) 41.74
elation charge-per 1.00IiR
34.78 0.00 6.96
45. Content Manip , 98.22 (2,70) 95.52
hour1.24 2.48 16.38
46. R&R Battinsulation-6"-R19-paper 64.00 SF 361.38 (3.17) 358.21
faced 4.66 2.92 60.22
64.00 SF
47. R&R Thin coat plaster over 1/2" 14.11 (0.47) 13.64
11.73
gypsum core blueboard 0.04 2.34
1.00EA 33.46 200.76 (28.00) 172.76
48. Mask and cover light fixture 0.20 2.57
49. Mask the floor per square foot-plastic 823.63 SF 474.59 (5.17) 469.42
and tape-4 mil O,g2 0.48 79.10
50. Scrape part of the ceiling&prep for 759.63 SF
paint 0.49 3.60 81.44
488.62 (3.91) 484.71
823.63 SF 276.66 1,659.93 (234.58) 1,425.35
51. Texture drywall-light hand texture 0 75 21.56 43.32
two coats 1,815.61 SF 7.46 44.81 (1.49)
52. Paint the walls and ceiling- 11.00 LF 3.27 1.38 15.50
oversized-3 1/4" 2.78 16.63 (1.13)
53. R&R Casing- 11.00 LF 1.25 0.10 10.98
oversized-two coats 1.88 11.30 (0.32)
54. Paint casing- 3.00 LF 3.09 0.15 0.43 7.14
55. R&R Window sill 0.04 1.26 7.57 ( )
3.00 LF 2.09 442.21 (8.78) 433.43
56. Seal&paint window sill 3.07 8.07 73'72 165.46
117.40 LF 29 58 177,43 (11.97)
57. R&RBaseboard-3 1/4" 117.40 LF 1.25 1.10 3 192.14
58, Paint baseboard,oversized-two coats 3 97 48.39 663.64 3,981.84 (789.70) 197.67
and finish wood floor 823.63 SF 32.94 197.67 (0.00)
59. Sand,stain, 823.63 SF 0.20 0.00
60. Final cleaning-construction-
Residential 92.88 1,369.82 8.2 18.81 1,091.83 7,126.98
Totals: Family Room
4/8/2015 Page:5
BENDIG BRYAN
'I
"- Insurance Claims Adjusters.Inc.
5s
)Inc. 11405 North Community House Road Suite 400
Charlotte,NC 28277
1-877-807-9669 Voice
1-97 70 Fax Height'.
F 1116- '5.5- Garage 793.18 SF Ceiling
-8'-r61"-a
1216.34 SF Walls 793.18 SF Floor
2009.52 SF Walls&Ceiling 88.65 LF Floor Perimeter
oma, 88.13 SY Flooring
115.15 LF Ceil,Perimeter
Opensinto BASEMENT
2+611 X 6'8"
Opens into]Exterior
Door 8'X 7' Opens into Exterior
Door 8'X 7' Opens into Exterior
Door 8'X T O&P RCV DEPREC• ACV
Door QUANTITY UNIT P�78
TAX 6.96 41.74 (0.00) 41.74
0.00 143.26
DESCRIPTION 1.00HR 147.30 (4.04)
Manipulation charge-per 3.72 24.54
71. ContentManip 1.24 (4.77) 537.33
hour �1_R19-paper 96.00 SF 90,36 542.10
elation-6 4.66 4.38 13.64
72. R&R ins 96,00 SF (0.47)
faced ]aster over 1/2" 2.34 14.11 166.37
73. R&R Thin coat p 11.73 0.04 193.34 (26.97)
g p�coreblueboard imEA 248 32.22
ht fixture 0.20 (4.74) 430.81
74. Mask and cover lig e foot-plastid 793.18 SF 72 58 435.55
75. Mask the floor per squat 0.44 466.80
0.52 (3.77)
and tape-4 mil &L rep for 697.18 SF 78,44 470.57 1,577.57
76. Scrape part of the ceiling p 0.49 3.47 1,837.20 (259.63)
paint 793.18 SF 23.86 306.20 (0,00) 190.36
all-light hand texture 0.75 31.72 190.36
77. Texture dryw tvyo coats 2,009.52 SF 0,20 0.00
78 paint the walls and ceilin8- 793,18 SF 304.40 3,567.87
79. Final cleaning-contraction 645.36 3,872.27
Residential 3839
Totals: Garage
Height:12121v
Basement 1934.42 SF Ceiling
6- 1934.42 SF Floor
2"J"
�,v- N 2162.36 SF Walls
T
"18.-+- Veiling .75.17 LF Floor Perimeter
I I 4096.78 SF'Walls&
Bm,m�t 214.94 SY Flooring
N 180.83 LF Ceil,Perimeter
55'8--� Opens into Exterior
- -56'4. 3'21,X 61 Bit
opens into GARAGE
Door 2'6"X 6'8" RCV DEPREC• ACV
O&P 47,75
Door QUANTITY UNIT PRICE TAX 818 49.10 (1.35)
1.24 1.24
DESCRIPTION 32.00 SF Pag
80. R&R Batt insulation-6"-R19-Paper 4/8/2015
faced
BENDIG BRYAN
i
i
a•u
stars.Inc•
Insurance Claims A ,
big. 11405 North Comm�tY
Hoose Road Suite 400
Charlotte,NC 28277
1.877-807-9669 Voice
-- 1-877-807-9670 Fax
e A-Dwelling 19,953.27
Sammar5'for Coverag 260.08
20,213.35
Line Item Total 2,013.34
Material Sales Tax 2,021.34
Subtotal $24,256.03
General Contractor Overhead (2,853.92)
General Contractor Profit
$21,402.11
Replacement Cost Value (2,500.00)
Less Depreciation
Actual Cash Value
$18,902.11
Less Deductible 2,853.92
Net Claim $21,756.03
Total Recoverable Depreciation
Net Claim if Depreciation. Recovered
Duane Smith
4/8/2015 Pag
BENDIG BRYAN
i
I
s Adjusters.Iuc•
Insurance Claim
Y
CA ,Inc• 11405 North CommnmtY g°use Road Suite 400
Charlotte,NC 28277
1-877-807-9669 Voice
- 1-877-807-9670 Fax
Recap by Room
Estimate:BENDIG BRYAN 239.04 1.200/0
Area:Exterior 1.20%
Front Elevation 239.04
Area Subtotal: Exterior 5.76%
1,149.61 x,92%
LEVEL 1,780.72
Area:SECOND
Bath
14.69%
Closet 1 2,930.33
L 537.37 2.69%
Area Subtotal: SECOND LEVE 3.85%
768.81 83,86%
6,756.11 27.53%
Area:Main Level 5,493AI.
Bathroom 1
FamilY Room 67.940/9
Kitchen/Diaing Room 13,555.70
Area Subtotal: Mam Level 15.98%
3,188.52 0,200/0
39.68
Area:BASEMENT
Garage 16.18%
Basement 3,228.20
19,953.27 100.00%
Area Subtotal: BASEMENT
Subtotal of Areas
19,953.27 100.000/0
Total
4/8/2015 Page;
BENDIG BRYAN
BASEMENT
35'Su
C N
-i'4
cq
Garage N N
„
2011011 55'8"
d in
M M
Basement
56'4" BASEMENT
page- 13
418/2015
BENDIG BRYAN
SECOND LEVEL
15' I
1414 M 13' 10"
13, 611
Master Bath
b
ter+ N
Closet 1 j
1410811
a
141211
SECOND LEVEL
4/g/2015 Page:15
BENDIG BRYAN
I,
0115IR-i'd Restorepro
101
21 A Sixth Road Woburn,MA 01801
Phone 800-847-0114
Home: 860-561-9672
Insured: Bendig,Bryan Cell: 860-490-9963
Property: 59 Berrington PI E-mail: madlaxbryan@gmail.com
North Andover,MA 01845-2152
Home: 59 Berrington PI 01845-2152
North Andover,MA
Business: 877-752-6422 x 21765
Claim Rep.: Wojahn,Kylie J. E-mail: KWOJAHN@AMICA,COM
Business: 12410 East Mirabeau Parkway Ste 500
Spokane Valley,WA 99216
Business: 781-438-0096
Estimator: Dan H.
Position: Project Manager
Company: Restorepro Inc.
Policy Number: 65042023CU
Type of Loss: Freeze
Claim Number: 60002095405
Date Contacted: 3/31/2015 1:22 PM Date Received: 3/31/2015 10:10 AM
Date of Loss: 3/17/2015 10:09 AM Date Entered: 4/20/2015 3:30 PM
Date Inspected:
Price List: MAEM8x APR15
Restoration/Service/Remodel
Estimate: BENDIG BRYAN
i
I '
-------------
Itestorepro
0.
21 A Sixth Road Woburn,MA 01801
Phone 800-847-0114
BENDIG BRYAN
BENDIG BRYAN QTY UNIT PRICE TOTAL
DESCRIPTION442,94= 531.53
1.20 EA @ 40.40
@
65. Single axle dump truck-per load-including dump fees 4.00 EA 10.10=
equipment(hazardous cleanup) 47.43= 189.72
66. Add for personal protective equip 4.00 HR @
67. Equipment setup,take down,and monitoring(hourly charge)
Main Level
Main Level QTy UNIT PRICE TOTAL
DESCRIPTION77.50= 232.50
68. Negative air fan/Air scrubber(24 hr period)-
No monit. 3.00 DA @
Height: 8' 11"
Kitchen 3' 11" X 4' Opens into Exterior
Window 2' 6" X 6' 8" Opens into Exterior
Door 21611 X 61811 Opens into Exterior
Door 216" X 618" Opens into Exterior
Door 2' 6" X 618" Opens into Exterior
Door 13' 111 X 6' 8" Opens into GREAT ROOM
Missing Wall- Goes to Floor 5' 811 X 6'8" Opens intoExterior
Door 2' 1" X 6' 8" Opens into Exterior
Missing Wall-Goes to Floor 51 2" X 31411 Opens into Exterior
Window 5' 211 X 3' 4" Opens into Exterior
Window 313" X 313" Opens into Exterior
Window 31211X 61811 Opens into Exterior
Missing Wall-Goes to Floor QTY UNIT PRICE TOTAL
DESCRIPTION80.00 SF @ 0.65= 52.00
13.20
1. Containment Barrier/Airlock/Decon.Chamber 4.00 DA @3.30=
3. Containment Barrier-tension post-per day 140.00 SFC 0.38= 53.2076.14
4. Protect-Cover with plastic 84.60 SF @0.90=
6. Tear out wet drywall,cleanup,bag for disposal 16.00 SF @ 0.68= 10.8876.56
7. Tear out and bag wet insulation 174.00 SF @ 0.44
-ht
Li (PER SF) 0.23= 19.46
8. NEPA Vacuuming- g 84.60 SF @
9. Apply plant-based anti-microbial agent
Height: 11' 5"
Great Room 5/8/2015 Page:
BENDIG_BRYAN
laestoreprO I
V-"I P, I V-1.99 urn,MA 01801
21 A Sixth Road Wob
I
I TwEl 11 1�"*�-
Phone 800-g47-0114 Opens into Exterior
Opens into Exterior
6''
5 X 6"
Window Opens into Exterior
Window
2'7" X 5' Opens into Exterior
2'7"X 5'
Window Opens into Exterior
Window
217" X 5' Opens into Exterior
Window
217" X 5' Opens into Exterior
Window
21711 X 5' Opens into Exterior
Window g'X 11' S" Opens into Exterior
Missing
Wall-Goes to Floor 21711 X 5' opens into KITCHEN
Window opens Opens into Exterior TOTAL
Missing Wall-GOeS to Floor 3' 10" X 11' S" QTY UNIT PRICE
48.90
Missing Fall 48.90=
1.00 EA @ 0.65= 247.00
DESCRIPTION 380.00 SF @ 23.10
3.30=
13. Contents-moChamber ve out then reset 7.00 DA @039 89.25
=
15. Containment Barrier/Airlock/Decon. 234 87 SF @ 446.55
post-per day 0.90=
16. Containment Barrier-tension p 496.17 SF @ o.68= 286.68
17, protect-Cover with plastic disposal bag for disp 421.59 SF @ 0 = 240.31
1 . Tear out wet drywall,cleanup, 114.12
546.17 SF @ 0.23=
20. Tear out and bag wet insulation 496.17 SF @ 14.13
Light-(PER SF) 0.38=
21. NEPA Vacuuming- g 38,75 LF @ 17.44
0.38=
22. Apply Plant-based anti-microbial agen 45.90 LF @ 0.29= 2,32
70. Tear out baseboard g.00 LF @
71. Tear out trim
72. Ducting-lay-flat
Basement
QTY UNIT PRICE
TOTAL
Basement 155.00
77.50=
2.00 DA @
DESCRIPTION hr eriod)-No monit.
63. Negative air fan/Air scrubber(24 P
Height:'
Opens into Exterior
Garage 2' 6" X 6' g" Opens into Exterior
Door 3' 2" X 6' S" Opens into Exterior
Door 9' 4" X 7' Opens into Exterior
Door 9' 4" XT Opens into Exterior
Door 9' 4"X 7' Opens into STAIRWELL
3' g1, X 91 51812015
Door
Missing W all-Goes to Floor
BENDIG BRYAN
I,
I
Restorepro
W.-CM4 l-P2,4_1091
21 A Sixth Road Woburn,MA 01801
Phone 800-847-0114 QTY UNIT PRICE TOTAL
DESCRIPTION1.00 EA @ 36.71= 36.71
58.50
25. Contents-move out then reset-Small room 90.00 SF @ 0.65=
38= 22.80
26, Containment Barrier/Airlock/Decon.Chamber 60.00 SF @ 0. 54.45
28. Protect-Cover with plastic 60.50 SF @ 0.90=
for disposal 0.68= 41.14
29. Tear out wet drywall,cleanup,bag p 60.50 SF @ 39.82
30. Tear out and bag wet insulation 90.50 SF @ 0'`0.23 3= 5.75
31. HEPA Vacuuming-Light-(PER SF) 25.00 SF @
32. Apply plant-based anti-microbial agent
Level 2
Level 2 QTY UNIT PRICE TOTAL
DESCRIPTION77.50= 155.00
64. Negative air fan/Air scrubber(24 hr period)-No monit.
2.00 DA @
Height: 10'
Master Bath 2' 6" X6' 8" Opens into Exterior
Door 2'7" X 5' Opens into Exterior
Window 6' i" X 4' Opens into Exterior
Window 2'6" X 61811 Opens into SHOWER
Door QTY UNIT PRICE TOTAL
DESCRIPTION1.00 EA @ 36.71= 36.71
32.50
34. Contents-move out then reset-Small room 50.00 SF @ 0.65=
30= 6.60
35. Containment Barrier/Airlock/Decon.Chamber 2.00 DA @ 3. 26.60
36. Containment Barrier-tension post-per day 70.00 SF @ 0.38=
0.90= 69.30
37. Protect-Cover with plastic for disposal 77.00 SF @ 20.40
38. Tear out wet drywall,cleanup,bag p 30.00 SF @ 0.68=
wet insulation O,qq.= 41.80
39. Tear out and bag 95.00 SF @ 17.71
40. HEPA Vacuuming-Light- ,,PER SF) 77.00 SF @ 0 23 =
41. Apply plant-based anti-microbial agent 5.50 LF @
0.38= 2.09
42. Tear out baseboard
Height: 8' 3"
Master Closet 2171, X 5' Opens into Exterior
Window 1' ill, X 6' 8" Opens into Exterior
Door 5/8/2015 Page:
BENDIG_BRYAN
i
5/8/2015 Page: 5
BENDIG._BRYAN
Phone 800-847-0114
QTY UNIT PRICE TOTAL
DESCRIPTION 48.90
1.00 EA @ 48.90=
44, Contents-move out then reset 45.00 SF @ 0.65= 29,25
45, Containment Barrier/Airlock/Decon.Chamber 2,00 DA @ 3.30= 6.60
46. Containment Barrier-tension post-per day 133.44 SF @ 0.38= 50.71
47. Protect-Cover with plastic 13.30 LF @ 4.20-- 55.86
48. Tear out wet drywall,cleanup,bag,per LF-up to 4'tall 36.72
54.00 SF @ 0.68=
50. Tear out and bag wet insulation 110.00 SF @ 0.44= 48.40
51. HEPA Vacuuming-Light- (PER SF) 54.00 SF @ 0.23 = 12.42
52. Apply plant-based anti-microbial agent 8,00 LF @ 0.29= 2.32
73. Ducting-lay-flat
Height: 8' 3"
Guest Bedroom
21611 X 61811 Opens into BATHROOM-2ND
Door 5' 1" X6' 8" Opens into Exterior
Door 2' 6" X6' 8" Opens into Exterior
Door Opens into Exterior
Window 5' S" X 5'
QTY UNIT PRICE TOTAL
DESCRIPTION 16.00 SF @ 0.23 3.68
61. Apply plant-based anti-microbial agent
=
Grand Total Areas:
10,5
5,18378 SF Ceiling 10.77 SF Walls and Ceiling
.
5,326.99 SF Walls 574.87 LF Floor Perimeter
5,183.94 SF Floor 575.99 SY Flooring
0.00 SF Long Wall
0.00 SF Short Wall 695.46 LF Ceil.Perimeter
5,183.94 Floor Area
4,763.62 Total Area 5,507.28 Interior Wall Area
5,070.52 Exterior Wall Area 729.64 Exterior Perimeter of
Walls
0.00 Surface Area
0.00 Number of Squares 0.00 Total Perimeter Length
0.00 Total Ridge Length 0.00 Total Hip Length
Restorepro
21 A Sixth Road Woburn,MA 01801
Phone 800-847-0114
Summary for Coverage A- Dwelling
3,943.73
Line Item Total 27.16
Material Sales Tax
$3,970.89
Replacement Cost Value (2,500.00)
Less Deductible
$1,470.89
Net Claim
Dan H.
Project Manager
5/8/2015 Page: 6
BENDIG_BRYAN
® �� 12Pctnrenro _
sement
61'I" 23'8"
23'
`pp iCl �D
3'3"-'
,3'3"
1 1 Garage
Basement T M
I
o 0
1 3'10"--
'10"-+ 3'10"
13'10" 3'6"
I�
64!11"
u`_I
Basement
BENDIG BRYAN 5/8/2015 Page=
tin Level
32
1 01.
-23'2"
373"
-37'
in r
Kitchen
11-2�17
7
2 7.. o Great Room
3'10"
-3'6"
00
81
19'5"
20'1'
Main Level
3ENDIG—BRYAN 5/8/2015 Page:
vel 2
52' 1"
3'6" 6'7" r= 41 13'4" TJ&
14' 11"
Master Closet Master Bathro6'8" Guest Bedroom
16'4'.Shower00 4
1
-151 lty 517"
lJ
L'O" t L
1 O
7141' ; 151711 C'7"
131"
I_f
Level
BENDIG_BRYAN 5/8/2015 Pag