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HomeMy WebLinkAboutBuilding Permit # 10/5/2015 ttORTH BUILDING PERMIT o���,ED ,61, '1'® TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION " Permit No#: Date Received sSgcHusArED ���y Date Issued: 10A- 4/ IMPORTANT: Applicant must complete all items on this page r/ „/ / ,,, , r r,iri r ri,/ / y/ r / / ,r,r,r / r e„ r r /r ri � �� /, ✓ ✓,,, / / �r l r f / r/ r r r,// r i >,// /� / ,/ / r r r r r ....m r ,r ao,a i a.✓tori , r r �, � / / ,� ///��ry � „ r �,/ ✓/ r r, „ rrr , r „ ,..//� / „% �l r � /f r r ./r// oil/✓! /r r r ri rrr,rr /. ,,,�i����,/��r,���r/���%�ir//��/hili vi,r/�/li,G(/�o/,2l%�r,ii///��/rrr.,/i�,/.��/„ ,o//r,!o,r//„//,,, �„c,,,, , p,,, ,,g,r,//,,,,.y,z „i :✓, TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building IpOne family ❑Addition ❑ Two or more family ❑ Industrial 'Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Se�t�c /%❑Well ❑ Floodplain ' ❑Wetlands ❑ Watershed D'stnct / ;c,, } [+ r,/ / r/,,,,,,r/ ,tri/i r///%//%rr/%�i o „r rr!, , /.: / i i'/i „✓//i�/r/!,, / r /: / /�rf!%��/.:, DESCRIPTION OF WORK TO BE PERFORMED: Re 40 Identification- Please Type or Print Clearly OWNER: Name: A-r,V �� °Po ur„� .,a. � Phone: 1,1-\Y -1*M -t4'V91 Address: ' ' c ' „Contractor Name honed ' rM r r / r rr r r r r r/ r � /� //. ,,/rrr ,✓. //r ,. /,,..,. ,, ,,,.. / ,. ,./ ,... ,/,. r / ,/i / r/ r/, // rr, /,rrr r„/ ✓,r /, / r/ / r , /- / / /, /i / r / I �r /, / / /✓// r 1r/ r� r r / % %,�� rn,r%,�r?p,,,r, ,rJ�►o t�,,,irrr,,, ,,,.r,r,.r,,,,,, gyp,,%�,, � ; 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: $ . C FEE: $ � Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund g g °e , Si nature of contracto Si nature of A ent/OwnerM ,,, ttORTH Town of Andover LANB ver, Mass, /0 COCNICK@WICK y1. ,®A0RRTE0 S BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System `�'l�t BUILDING INSPECTOR THIS CERTIFIES THAT .......��......�....��..�:l�!� (............................................................................ � has permission to erect .......................... buildings on . a....:��~.s. :5 .............................. Foundation Rough to be occupied as .................. .:MecAr ...... .��.......................................................... 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 MONTHSELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service .......... ..... . ,..,.�............................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occup-y Buildina Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final Lathingr Dry Wall ToBe one FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. 98 Fort Street Keviri , IT, North Andover,MA 01845 -plely • PH:978-688-5335 Building tr r • FAX:978-688-7207 Proposal °Po: Don McDaniel/Carol Disney 92 Prescott 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 Co nmonwealth of Massachusetts.Inquiries about registration and Status should be made to the Director,Hone From: Kevin Murphy R000m 101,Bent ost Mntract A 02106(61Tk772One i859 on Placa, Date: 10/5/2015 .lob: Bath Remodel Date of plans None Archlitech None Same Section 1- ort 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 9/15115. Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 11/15/15.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-Warminty 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 � Keviti Murphy Page 2of4 flwikfiqg Cmau�"Un, � oaForest Street North Mdover,MA 01845 FAX 978-6W7207 � � Gmnsmm| � � Proposal is to renovate existing three fixture bath. Permits will be obtained by contractor. Demolition Existing bathroom wU be completely gutted. � Building � Any miscellaneous materials required to fix rotted floor will be supplied by contractor. Plumbing Plumbing required to remodel bathroom will be provided. Fixtures to remain in same locations. Copper pan for new tile shower will be supplied and installed. Plumbing fixtures to be supplied by owner, installed by contractor. Electrical Bocthne| mmrh required to wire bathroom to code will be provided. New Panasonic fan /light will be supplied and installed.Any surface mounted fixtures(wall sconces)to be supplied by owner, installed by contractor. | Insulation � FiborQksoe insulation will be installed in exterior wall. Plaster Bathroom will be blueboarded and skimcoat plastered. Um%eriorTrim/Dmomm Interior trim will be supplied/installed h}match existing. Flooring ll|e floor and shower will be supplied and installed. An allowance of$7 per square foor has been included for tile materials. Other Allowances An allowance of$2000 has been included to supply and install glass shower door. Painting There has been noallowance made for any painting. Waste Removal � All demolition/construction debris vvUbod ofbvoVOt�u�or . _,---_ ^ . � � � � Kevin MurphV Page 4 of 4 Building Contractor 98 Forest Street North Andover,MA 01845 PH:97&68&5335 FAX 978688-7207 Section IV—Price Schedule We hereby propose to furnish material and labor—complete in Accordance with above specifications for the sum of... ... ... ... ... ... ... ... ... ... ... ....$ 14,700 Payment to be made as follows: PercentagelItem Description Amount 1 Permit obtained / demolition complete $2700 2 Plastering complete $5000 3 Tile complete $4000 4 Job 100% complete $3000 Total 4 $14,700.00 -Notice:No agreement for Horne improvement contracting work shall require a dawn payment(advance deposit)of more that one-third of the total contrail price of the total amount of all deposits or payments which the contractor must make,in advance,to order ardor otherwise obtain delivery of special order materials and equipment,whichever 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 DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANC(SPACES Signature �� ' Datew � u �M� Signature .G Date The Commonwealth of Massachusetts Department ofIndustrialAcci(lents I Congress Street,Suite 100 Boston,M4.02114-2017 www.mass.gov1dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE TILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: '13- CV' SA­ City/State/Zip: %,j,,, 1% C,;1ITPhone L" Are you an employer?Cheelc the appropriate box: Type of project(required): I.Calarnaemployer with k, employees(full and/or part time).* 7. F1 New construction 2.0 1 am a sole proprietor or partnership and have no employees working for me in 8, 13,,Remodeling any capacity.[No workers'comp.insurance required.] 3.QI am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. F1 Demolition 4.FJ I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 F1 Building addition ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.n 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.iDsuranceJ 6.FJ 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'comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing theirworkers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then Wr6 outside contractors must submit a new affidavit indicating such. tContractors that checkthis 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 art:an employer`ilrat is providing ivorlrers'compensation irtsta•attce for my employees. Below is the policy and job site information, Insurance Company Name: Policy ff or Self-ins.Lie.ff: tC-a, °­ k,75" 3"Ll Expiration Date: Job Site Address: City/State/zip: tjo" In "",A L'A."', U'� 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 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 herecellify under thepains andpenalfies ofpsiywy that the information provided above is true and correct Si nature: it, 2-2Date: Phone 4: Official use only. Do not iprile in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): i 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(MMUEIYYYY) IFS CERTIFICATE OF LIABILITY INSURANCE 7/1 5/2015 THIS CERTIFICATEW ISSUED ASA MATTER OF INFORMA110HONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELYOR 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 REPRESENTATIVEOR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificateholder is an ADDITIONAUNSURED,tho policy(les)must be endorsed.It SUBROGATION IS WAIVED,subject to the termsandconditionsofthe policycartainpoliclesmayrequimnendarsomentA statementon thiscertificatedoes not conferrights to the certificateholder in lieu of such endomement(s). PRODUCER CONTACT NAME Sandi Munroe P ROBERTS INS AGCY INC a.". FAX 1060 Osgood Street. �MNLa.Ex: 878) 683-8073 Na: (578)6��— 147 North Andover, MA 01845 18qq5 ADRESSnd1 :mprobertsinsurance.com INSURER(S)AFFORDING COVERAGE NAICM INSURERA: MERCHANTS INSURANCE INSURED KEVIN MURPHY BUILDING & REMODELING INSURERS: GUARD INSURANCE 169 BOXFORD STREET INSURERC: NORTH ANDOVER, MA 01845 INSURERD: INSURER E INSURERF: 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, '... EXCLUSIONSANDCONDITIONS OF SUCH POLICIES.LIMITS SHOWNMAY HAVEBEENREDUCED BYPAID CLAIMS. avna POLICY EFF POUCYEXP '.. TYPE OFINSURANCE POLICY NUMBER 22= LIMITS X COMMERCUILGENERALLIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMSMADE OCCUR PREMISES ..o�r--I $ py MEDEXP(Anyorrel>gso) $ 15,000 RCD;�2068995 11/22/14 ' `/ /D.5 PERSONAL&ADV INJURY $ INrlL GENI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 [qp--,-y JIEECCTLOC pRODUGTS-COMP/IX°AGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT F.axidenl $ 1,000,000 BODILY INJURY Person) $ ANYAUTO ALL OWNED SCHEDULED MCA7013608 1/23/15 1/23/16 BODILY INJURY(Per accident) $ A AUTOS AUTOS NON-0WNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per acddent $ '.. UMBRELLA UAB OCCUR EACH OCCURRENCE $ 1,000,000 A :E1 EXCESS LIAR CWMSMADE AGGREGATE $ 1,000,000 CC7P9145304 1/22/14 11/22/15 DED I I RETENTION $ $ WORKERS COMPENSATIONPER YIN AND EMPLOYERS'LIABILITY STATUTE ER _ 500 000 ^"niOiE1�'x'r"ff E.L.EACH ACCIDENT $ , W I A (M.rdvt.0. Exctuotni EL DISEASE-EA EMPLOYEE $ 500,000 (Mandataryln NN) R �tEWC633734 7/01/15 7/01/16 it yea.dee«aa Under 500,000 DESCRIPTION OFOPERATIONS below E.L DISEASE•POICY UMIT $ '.. I F_ - - - -A_ DESCRIPTION OFOPERATIONSI LOCATIONS/VEMCLES(ACORD 101,Additlonal ftemad:e Schelde,may beaaached B moa mace la requimd) CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE W91 BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE jr N ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction 5upervkor License: CS-053099 KEVIN W MURPHY 98 FOREST ST `, North Andover NfA 018hS J' r. Expiration Commissioner 06/29/201! _ ��e (poa�rr��eo�acae�cl��.c���aa�ac�cree\ Office of Consumer Affairs&Busibess Regulation WE'pirtion: OMEIMPROVEMENT CONTRACTOR egistration: 101874 Type: 6/29/2016 Individual KEVIN MURPHY Kevin Murphy 98 FOREST ST. N.ANDOVER, MA 01845 Undersecretary { 9/10/2015 Fsvd:.Department of Public Safety Authorized Payment Confirmation-michellerochel4@gmail.00m-Gmail Click h Gmail COMPOSE. Fwd: Department of Public Safety Authorized Payment Coi Inbox(2,079) Kevin Murphy Starred to me Important ------ Forwarded message---------- Sent Mail From: <ConveniencePayCIientSu ortC�hp.com> Drafts (4) Date: Wed, Jun 10, 2015 at 5:42 AM Facebook Subject: Department of Public Safety Authorized Payment Confirmation To: kevinmurihybuildingPgmail.com Notes Personal This is an electronically generated acknowledgement of your payment to Recipes Department of Public Safety Payment. Please print this message or Travel save it on your computer for future reference. More Here is your payment information: License Number: CS-053099 Payment Date/Time: 6/10/2015 5:37:19 AM (ET) Payment Amount: $100.00 Convenience Fee Amount: $2.49 Method of Payment: Visa Card Number: ***"3909