HomeMy WebLinkAboutBuilding Permit # 12/28/2015 BUILDING E IT ®1 %aoRrH�g4ED ,g� 'o
TOWN OF
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APPLICATION FOR PLAN EXAMINATION M
Permit No#: l° k Date Received 4
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Date Issued:---A 2
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building C, One family
ddition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
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DESCRIPTION OF WORK TO E PERFORMED:
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Identification- Please Type or Print Clearly
OWNER: Name: k -,, mow, Phone:(- ' ` -'1>1
Address: i) C1, e:4 .Il 5 -411-
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ARCHITECT/ENGINEER Phone:
Address: ,Wi 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: $ ”" ��r FEE: $ tl
Check No.: \ — Receipt No.: EU
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund
Signature of Agent/Owner ,, �” Signature of contractor -
Plans Submitted" Plans Waived ❑ Certified Plot Plan Stamped Plans ❑
TYPE"OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art ❑ Swinuning Pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Pennanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
PLANNING & DEVELOPMENT Reviewed On �✓ Signature_
OMMENTS �� � 'a1( le `a tv t � � �" �
')( (IV
CONSERVATION Reviewed on Si nature
COMMENTS V` _LA ��_c � �. �1 ,v� (00
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature& Date Driveway Permit
DPW Town Engineer: Signature:
Located 384'Osgood Street
FIRE DEPARTMENT Temp Dumpster on site yes; ~ro,
Located at 124 Main Street
Fire Department signature/date
,COMMENTS: ,
'Town of Andover
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2`'o �AK� ver, Mass, ft,6w n
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COCHICHew°cx "1•o
BOARD OF HEALTH
Food/Kitchen
PERMIT LD Septic System
THIS CERTIFIES THAT .......... BUILDING INSPECTOR
.. .;t',. ........... ........... .... ......... ............ .. .........
. . ..... ... .. .. .. ..
Foundation
has permission to e4ecl ,
.. ..
................ buildings on ...
i
J
Rough
.. ....... ..... .................
Chimneyt® be occupied
accepting. .. MOS.. . . ............. ..
provided that the parson 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 Inspecti ,Alte ation and
Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR
Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION Rough
Service
e: ::. ,.�...: .... ....
................ Final
BUILDING INSPECTOR
GAS INSPECTOR
Occul2ancE Permit Required t® Occupy BU Rough
Display in a Conspicuous Place on the Premises ® Do Not Remove
Final
No Lathingr Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected ve the Building Inspector. Burner
Street No.
Smoke Det.
98 Forest Street
phyNorth Andover,MA 01845
KervNin" mur 0 PH:978-688-6336
Building o nt r cto r • FAX:978-688-7207
Proposal
To: Scot&Kristen Freda
120 Osgood 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}7278595
CC:
Date: 12/19/2015
.lob: Master bedroom addition/bath remodels
Date of plans: 12/15
Architect: Steve Foster
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 1/15/16.
Barring Delay caused by circumstances beyond Contactors control,the work will be completed by 6129/16.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 fumished 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.
Page 1 of 5
Kevixa Marphy Page 2 of 5
Building Contractor
98 Forest Street
North Andover,MA 01845
PH:9786885335
FAX:978-688.7207
Section 111—Scope of Work
General
Proposal is to add 24'x24 master bedroom/bath,and renovate two existing bathrooms. Building plans,structural
engineering,and plot plan to be provided by owner. Building permit will be obtained by contractor. No allowances
have been made to obtain any variances, conservation,or historical society approvals
Excavating
Excavation required to install full basement area will be provided. Any additional fill will be removed from site.
Backfilling and rough grading will be provided. No allowance has been made for removal of ledge, relocation of
underground utilities, lawn sprinklers, landscaping, or lawn repairs.
Foundation
Poured concrete foundation,for full basement area,will be provided as shown on plans. Footings will be 10"x20",
walls will be 10"thick, grade to match existing. Four inch thick concrete floor will be poured over crushed stone
base. Interior perimeter drain will be installed under floor. Concrete cutting will be performed to gain access to
new basement area. Opening will be approximately 42"wide.
Building
All frame, roof, and siding materials will be provided to match existing/meet code/as shown on plans. Floor
joists will be 2x10, exterior walls will be 2x6, roof rafters will be 2x10. All floor,wall, and roof sheathing will be fir
plywood(3/4 on floor, 1/2 on walls, 5/8 on roof) . Roof shingles to match existing. Ice and water sheild will be
installed at all roof edges and valleys. Exterior walls will be wrapped with Tyvek or equivalent. Cedar siding to
match existing. Corner boards and window trim will be Azek. Harvey windows will be supplied and installed as
shown on plans/to match existing. Interior petitions will be 2x4.
Plumbing
Plumbing required to add four fixture master bath,and renovate two existing baths will be provided.A second sink
will be added in existing main bathroom.
Electrical
Electrical work required to wire addition and bathrooms to code will be provided. Panasonic fan/lights will be
supplied and installed in each bathroom. Ten recessed lights have been included. Surface mounted fixtures (
wall sconces, ceiling fans) to be supplied by owner/installed by contractor. General layout to be approved by
owner prior to rough. No allowance has been made to upgrade existing electrical service. Phone / cable /
computer lines to be roughed in by electrician,to be connected by service provider,at owner's expense. Any high
def TV wiring, or surround sound to be done by others. Electrical line to pool will be relocated as required.
Heating/Air Conditioning
A separate zone of forced hot water heating will be added in new master bedroom/bath area. Heat in existing
baths to remain. New heat enclosures will be supplied and installed in bathrooms. Condensor for central air will
be relocated. Central air conditioning will be provided in new master bedroom.
Insulation
Kevin
MuYlphy Page 3of5
Building Contractow
98 Forest Street
North Andover,MA 01845
PH:978686-5335
FAX:978£$6.7207
Addition and bathrooms will have fiberglass insulation installed to code.
Plaster
Addition and bathrooms will be blueboarded and skim coat plastered. Walls will be smooth, ceilings to match
existing.
Interior Trim/Doors
Pre-primed interior trim and doors will be supplied and installed to match existing.
Painting
All interior and exterior painting will be provided. One coat of primer, and two coats of finish will be applied to all
painted surfaces.
Flooring
Hardwood floors will be supplied, installed, and finished in master bedroom. Three coats of oil based urethane
will be applied.
Tile floors will be provided in all three bathrooms. Walls around tub in main bath, and entire shower in master
bath,will be tiled.An allowance of$6 per square foot has been included for tile materials.
Waste Removal
All demolition/construction debris will be disposed of by contractor.
Demolition
Two existing bathrooms will be completely gutted.
Other Allowances
An allowance of$1500 has been included to supply and install shower door in master bath, No allowance has
been made for glass tub enclosure in main bath.
An allowance of$1500 has been included to supply vanity/counter in master bath.Vanities/counters for existing
baths, to be provided by owner.
An allowance of$2000 has been included for plumbing fixtures in master bath. Plumbing fixtures in existing baths
to be provided by owner.
Items Not Included
There have been no allowances made for any built in units/custom cabinetry.
Kevin " Page 5 of 5
Rding Contractor
98 Forest Street
North Andover,MA 01845
PH:9786885335
FAX:9786887207
Section IV-Price Schedule
We hereby propose to furnish material and labor—complete
in Accordance with above specifications for the sum of ........................... ..........$ 133,000
Pavment to be made as follows:
Percenta a/Item Description Amount
1 Permit obtained / Deposit $3000
2 Foundation poured $15,000
3 Roof frame complete $20,000
4 Siding /windows installed $15,000
5 Rough plumbing /electric complete $15,000
6 Plaster in addition complete $10,000
7 Trim /tile in addition complete $15,000
8 Addition complete $10,000
9 Tile complete in two existing baths $18,000
10 Job 100% complete $12,000.00
To 110 $133,000.00
"Notice:No agreement for Home improvement contracting work shall require a down payment(advance deposit)of more that one-third of the trial contract price of the total amount of all deposits or
payments which the contractor must make,in advance,to order andlor othenaise obtain delivery of special order materiats 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 BLANK SPACES
Signature Date
/
Signature &'&�Jzlt Date
i
BrAMI
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The Commonwealth of Massachusetts
Department ofIndustrialAccidents
I Congress Street,Suite 100
Boston,MA 02114-2017
ivww.mass.gov1dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PE RMTTING AUTHORYM
Applicant Information Please Print
Name (Business/Organization/Individual):
Address: 1ZfJ-' r'Ctl,t",
City/State/Zip: tjv ,, \0
Are you an employer?Check the appropriate box: Type of project(required):
101 am a employer with employees(full and/or part-time).* 7. F1 New construction
In I am a sole proprietor or partnership and have no employees working for me in 8. FJ Remodeling
any capacity.[No workers'comp.insurance required.]
3.0 I ama homeowner doing all work myself.[No workers'comp.insurance required.] 9. R Demolition f 10714 Building addition
4.FJ I am a homeowner and will be hiring contractors to conduct all work on my property. twill
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.r_J 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet
These sub-contractors have employees and have wrance.:
workers'comp.insu 13.F�Roof repairs
6.M We are a corporation and its officers have exercised their right of exemption per MGL C. 14.n Other
152,§1(4),and we have no employees.[No workers'comp.insurance required.]
L
*Any applicant that checks box#1 must also fill out flic section below showing theirworkers'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.
tContTactors that clieckthis 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.
laiiialt eiiil)loyei,iliatispi,oviditigipoi-Irei,s'copitpeiisationinsurance for'iiiyemployees. Below is the policy azul job site
inforniation.
Tnsurance Company Name: Ly,^
Policy ff or Self-ins.Lie.it: \,L,, 13 Expiration Date:
e)" City/State/Zip: l,_k
Job Site Address:
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$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
Ido heebyerfify under the pains andpenattles ofpeiftny that the informationprovided above is true and correct.
ur
Sienat Date: C-)-k-un" (ts
Phone#: G'r� ;k
Official use only. Do not sprite in 1N's-Mea,to he completed by city or town official
City or Town: Permit/License
Issuing Authority(circle one): i
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
DATEMrDDYYYY)CERTIFICATE OF LIABILITY INSU NC13,
15
THIS CERTIFICATEIS ISSUEDASA MATTEROF INFORMATION ONLY AND CONFERSNO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMA71VELYOR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATNBDR PRODUCER,AND THE CERTIFICATEHOLDER.
IMPORTANT:If the cerURcateholder is an AODITIONAUNSURED,the pol(cy((espnust be endorsed.N SUBROGA11ONIS WAIVED,subject to
the terms and conditlonsof the Policypertain policiesmayrequfrean endorsement.A statementon thlsceri icatedoesnot conferdghts to the
certiflcateholder in(feu of such endorsement(s).
PRODUCER CONTACT
NAME: Sa,Y'l.di. Mf.TT1X,'tD
M P ROBERTS INS AGCY INC PHONE
AJC,Na,Exit: (978)683-8073 A/CFAX,Nn: (9"76)68.3�-314'7
1060North OA dod Street AE-MAILDDRESS: s ndi.@ Okr rtsinsurance.com
ndover, MA 01845
INSURER($)AFFORDING COVERAGE NAICR
INSURERA: MERCHANTS INSURANCE �
INSURED KEVIN MURPHY BUILDING & REMODELING INSURER B: GUARD INSURANCE
98 FOREST STREET INSURERC:
NORTH ANDOVERf MA 01845 INSURERD:
INSURER E
INSURERF: ''...
COVERAGES CERTIFICATE NUMBER:
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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.OMITS SHOWNMAY HAVEBEENREDUCED BYPAID CLAIMS.
LM TYPEOFINSURANCE POLICY EFF POUCYEXP
POLICY NUMBER LIMITS
COMMERCIALGENERAL LIABILITY
EACH OCCURRENCE s 11000,000
CLAIMS-MADE OCCUR El PREMISES its oau--I $ .0 0 o
SOPI068945 11/22/15 11/22/16 MEDEXP(Anycneperson) $ 1!5,000
PERSONAL&ADV INJURY $ 2,000,000
yy INCLUDE1
'..
GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE $ 2 r to 0 0 7 0 0 0
N
PCUCV JEC LOC
PRODUCTS-COMP/OPAGG $ 2,0001000
OTHER
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
Ea accident $
ANYAUTO ^r'w ^�e^fr q
ALL OWNED SCHEDULEDYNEU MCA7013608 7 1/23/15 01/23/16 BODILYINJURY(Per peraon) $
AUTOS AU705 BODILY INJURY(Per accMeol) $
HIRED AUTOS ATO. PROPERTY DAMAGE
Per acddent
a
UMBRELLA LRB OCCUR1,000,000
'..,,..
F1EACH OCCURRENCE $ 1 y 0 0 0/0 0 W '...
EXCESS LIAB CLPIMS�MADE AGGREGATE $ 1,000,000
CUP9145304 1/22/15 1/22/16
DED RETENTION $ $
WORKERS COMPENSATION PER OhF
AND EMPLOYERS-LIABILITY STATUTE ER
_ _ YIN nn hPrh
B omcswoeamwwia Ue. IFwrm N/A ,q E.L.EACH ACCIDENT $ 500®r0 VlF
if nd.I.Na NH) WC633734 7/01/15 7/01/16 E.L.DISEASE-EA EMPLOYEE g 500,000
Il yes,desaribe under
DESCRIPTION OFOPERATIONS below E.L DISEASE-POLICY OMIT $ 500,000 '..
DESCRIPTION OFOPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional RamarksSdreddule,may be atladred H more space is regWred)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE '..
TOWN OF NORTH DOV THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ryryy rryT qq ACCORDANCEWITHITHE POLICY PROVISIONS.
NORTH ANDOVER01845 AUTHOPJZEMREPRK
01988-2014 ACORD CORPORATION. All rights reserved.
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