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HomeMy WebLinkAboutBuilding Permit # 3/8/2016 NORT11, BUILDING PERMIT TOWN OF NORTH ADOVER APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received �SS•�C►aus�c Date Issued: NdPORTANT: Applicant must complete all items on this page LOCATION ,°�_L��t �� dti' S Print PROPERTY OWNER 01 C _fie i'l LC Print 100 Year ttructure yes rn MAP r ' PARCEL: 2- ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ZAlteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other : t r )y, r d r<5+xfi , 1,,,.�-rrrw�/ ' .,;, 4.� rr,! =r ''.r g r' f x`a f LeAIM9/r'`� ,; ,r�,t ,;; t 3 ! .✓� es r r'�.✓ %' rr. '...S .A, !}s e tic Af ❑ Flaod larn D Wetlands Y ❑ U\/atersed,Di tact P Well{ £ :- p s r ; ,. I ,=,n, r ��•"-�'„� 2}u'`<;,a .iy';k, ,a�'g,? '!'�` r ''� ��i 'Ss�� p/r` ;,-*�, ,�r�;4i� ,. �",fi''��ry`�� �'��� �1 �? � ,skit'' d a�er/S DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: (,..,i 5tj ecvie ,� Phone: Address: (L,� i Cc) Phone: 9?0 -6-19 X72-6 Contractor Name: I"�-��� ��°�t S Cv c:-f ;r� Email. � -t le 5 r ,d.1 "'cvi d-Uc �CN c& _ ;A Address: IPC) f3o .,, 4-f`s' r 1✓I d cv-e r--, 6 d Supervisor's Construction License: iJ Ly Exp. Date: � l Home Improvement License: IL �1 Z 3 Exp. Date: �Y l I ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$9000.00 HE TOT STIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ ` � °' a EE: $ l Check No.: Z Receipt No.: I MOTE: Persons contracting with unregistered contractors do not have access to th g al; ty nd IAORTH Town of Andover 0 No. 9%- 2A 11 1 Very 1VIaSS, (O 'Q CO[HICHlw.C.t 1' �9S N ATE D pYa,`,i5 11BOARD OF HEALTH Food/Kitchen PERMIT T L EDEmwmft� Septic System THIS CERTIFIES THAT ......... .....L �,!:! ` . ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, BUILDING INSPECTOR .6-.cam..................... ...... .... . .... ..... Foundation has permission to erect .......................... buildings on .� ......h'i': .........................�— Rough to be occupied as ....... 1A.................................................... 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 e� Final PERMIT EXPIRES IN 6 MONTHS ELECTRICALINSPECTOR UNLESS COSTRUCTI ARTS Rough Service ..............b.. ........................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to 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. Construction Co, REMC3D1:LING tiPL"C:IALISTS KeenConstructionCo.com McSweeney,Trish & Mike 23 Middlesex St. N.Andover, MA 01845 Contract#5574; Appendix A March 5, 2016 Remodel kitchen: • Remove and dispose of existing cabinets,counters, appliances,wallboard and flooring • Remove existing wall between kitchen and front room • Remove electrical wires in wall and heat, relocating heat to a toe-kick heater under sink base • Supply& install appropriate triple 2" x 12" beam for 8'10" clear span • Relocate door from mudroom to accommodate kitchen design • Supply& install fiberglass one panel door unit with half glass, including horizontal grids to create three panes of glass.Supply&install Schlage Plymouth satin nickel lockset. • Update electrical as needed, adding six recessed light fixtures, customer supplied light fixture over island and hallway, adding cable outlet in corner cabinet, adding additional outlet in hallway, hall closet& pantry cabinet ($3500 electrical allowance) • Update plumbing as needed, installing customer supplied fixtures and appliances($2000 plumbing allowance) • Install customer supplied range hood and install exhaust as needed to exterior hood • Remove laundry box in bathroom, capping pipes for future use • Insulate walls to code • Supply& install blueboard and skimcoat plaster to smooth finish, including adjacent wall in mud room and patch in bathroom • Supply& install trim to match existing • Repair exterior window sill and air conditioner support as needed • Paint walls, ceiling and trim • Install customer supplied cabinets and related trim • Supply& install approx. 210 sq. ft.of 2%" Oak flooring to match existing • Sand and seal new floor up to old floor Total Price:$28,609.00 (twenty eight thousand six hundred nine dollars) Prices do not include cost of plumbing fixtures,cabinets, counters, appliances or repairs to any unusual, unsafe or non-code compliant existing conditions not addressed in this quote. 1175 Turnpike St. page 1 of 2 P:978-691-5201 N. Andover, MA 01845 F: 978-682-3231 GSL #076691 Soles@KeenGonstructionGo.com HIG #108383 6Cons(rucfoCo , RC3DULINC KeenConstructionCo.comM Payment Schedule: $4000 due upon signing contract $5000 due when rough electrical and plumbing is complete $5000 due when plaster is complete $5000 due when floor is complete $5000 due when cabinets are installed $4609 due at completion of contracted work Custo er Robert A Keen 3 & 31&111 � Date Date 1175 Turnpike St. page 2 of 2 P: 978-691-5201 N.Andover, MA 01845 F: 978-082-3231 GSL #076691 Sales@Ke2nGOn9tructIOnCoxonn HIG #108383 J S,i z KEEN CONSTRUCTION CO. ° 1175 TURNPIKE STREET PROPOSAL NORTH ANDOVER,MA 01845 All home improvement contractors and subcontractors Tel: (978)691-5201 engaged in home improvement contracting, unless Fax:(978)682-3231 specifically exempt from registration by Provisions of - Chapter 142A of the general laws, must be registered Submitted T I- �/, f/ CufV�/, with the Commonwealth of Massachusetts. Inquiries T°' �1 ) ' I f)e I about registration and status should be made to the Director,Home Improvement Contract Registration,10 j JC Park Plaza, Room 5170, Boston, MA 02116 617-973- \ 1 f �j 8787 Owners who secure their own construction �. r1�-��Vl��� 11� C'J zq'J related permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c.142A. PHONE Dgj / REGISTRATION NO. EIN NO. �J 2U1l✓ MA. H.I.C. 108383 46—3783401 > C/S=Customer Supplied S+I=Supply+Install Pr See Attached Appendix A We hereby submit specifications and estimates for work to be performed and materials to be used: &v1'IO- e l > Construction related permits: Contractor will not begin the work or order the materials before the third day following the signing of(his Agreement,unless specified here in writing. Contractor will begin the work on or about (date). Barring delay caused by circumstances beyond Contractors control,the work will be completed by (date).The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Agreement. WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of 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 worj manship.The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. '.. We Propose hereby to furnish material and labor-complete in actor/dance with above specifications,for the sum of :E,,g_f74 1 F,,-- hl 7f`OCI jCIN� '51"X Pf 7d wd -- dollars($ 2-al��)9,OCA Payment to be mad as follows )' % ($ ) upon signin Contract; )))yyy� ROBERT A. KEEN upName of Contractor/Designated Registrant ($ ) o ,c p�ean 1175 TURNPIKE ST. W�� t( Street Address wpon completion of N. ANDOVER, MA 01845 City I Slate - - � ($ ) shall be made forthwith upon (978)691-5201 (978)682-3231 completion of work under this contract. Ph no Fax 7" Notice: No agreement for home improvement contracting work shall require a �� '{r T '� >clown payment(advance deposit)of more than one-third of the total contract price "Amen'lsa', or the total amount of all deposits or payments which the contractor must make,in _j - advance,to order and/or otherwise obtain delivery of special order materials and Amlwr edS equipment,whichever amount is greater. Note:This proposal may he withdrawn by us if not accepted within days. Acceptance Of Proposal-I have read both sides of this document and all attached documents 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 of 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 Z-, Date `� l> lC Signature Date IMPORTANT INFORMATION ON BACK DO- The Commonwealth of Massachusetts Department oflndustrialAccidents . 1 Congress Street,Suite 100 Boston,MA 02114-2017 �1b Sv� www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FH,ED WITH THE PERMITTING AUTHORITY. Please Print LegiblyADDlicant Information /' Name(Business/Organization/Individual): 6),4V-1 C_co ry Address: -),x i City/State/Zip: �� IL,-)n Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with L- employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9, ❑Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition <1 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 11.❑Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole proprietors with no employees. 12.E]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 14.❑Other 6.0 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.] 999NME that checks box#1 must also fill out the section below showing their workers'compensation policy information. who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. at check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have the sub-contractors have employees,they must provide their workers'comp.policy number. loyer that is providing worlters'compensation insurance for nay employees. Below is the policy and job site information. Insurance Company Name: �r'�, ler-5 Io- _ — Policy#or Self-ins.Lic. 14 v IJ /9 9 I '5<2'—Z Expiration Date: I U yin Job Site Address: •� �J I",!�Cl (�S City/State/Zip: Al, dn dwer /V//7 Ci t y 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 cert er e p s and penalties of perjury that the information provided above is true and correct. 3 6 �, Date: Si nature: Phone t 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#: ACCWhi® CERTIFICATE OF LIABILITY INSURANCE DATE(MM DDlYYYY) Ill 10/23/2015 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(les)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 CONTACT Barbara McDonough Gilbert Insurance Agency, Inc. PHONE (781)992-2225 NC No:(781)942-2226 137 Main Street E-MAA DDRESS :bmcdonough@gilbertinsuranee.eom INSURER(S)AFFORDING COVERAGE NAIC q Reading MA 01867-3922 INSURER Norfolk & Dedham Insurance 23965 INSURED !NSURERB:Safety Insurance Company 39454 Keen Construction Company INSURER C:Travelers Ins. Co. 0031 483 Chickering Road INSURER D: INSURER E: North Andover MA 01845 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1552101779 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, EXCLUSIONS AND.CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADD B POLICYEFF POLICYEXP LTR POLICYNUMBER MhVDDr(Y dM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE To REll A CLAIMS-MADE X❑OCCUR PREMISES(s occurrence) 100,000 1m-P-010078/000 3/13/2015 3/13/2016 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JET LOC PRODUCTS-CCMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILELIABILITY COMBINED SINGE-I-MIT e accident $ 1,000,000 B ANY AUTO BODILY INJURY(Par person) $ ALL OWNED TWNEO X ASCHEUTOSU�D 6228807 COM 01 5/23/2015 5/23/2016 BODILY INJURY(Par accklenl) $ X HIRED AUTOS X NON�OWNED PROPERTY DAMAGE $ AUTOS a ids 1 Underinsured motorist $ 100,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CWMS-MADE AGGREGATE $ DED I RETENTION $ WORKERS COMPENSATION —T-.PTATU E AND EMPLOYERS'LIABILTY YIN ANYPROOMEIJ�0.NER/E WTIVE ❑N f A E.L.EACH ACCIDENT T. 100,000 C OFF(Mandalay In NH) 6RUB-9991M58-2-15 10/8/2015 10/8/2016 E.L.DISEASE-EA EMPLOYE $ 100,000 If qas,describe under DESCRIPTION OF OPERATIONS b.1— E.L.DISEASE-POLICY LIMIT I$ 500,000 '.. DESCRIPTION OF OPERATIONS f LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) CERTIFICATE HOLDER CANCELLATION (978)623-8320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE M Gilbert, CIC/BARBAR ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) Massachusetts -Department of Public Safety Board of Building Regulations and Standards Lllll\tl Ll ltll/ll JIJ�/CI Ylllll License: CS-076691 ROBERT AKEEN:` 12 E WATER ST North Andover ADL 0 r J jrl"�` ` Expiration commissioner 08/16/2017 sy,, �✓/�� l(�o7Jt1JL07![LBC!-�I�OU(/�CG.IJCGCJLCCJG'�� ice of Consumer Affairs&Business Regulation E IMPROVEMENT CONTRACTOR J egistration 108383 Type: ExpirationSupplement Car KEEN CONSTRUCTION-CO. ROBERT KEEN 1175 TURNPIKE ST � ,� NO.ANDOVER, MA 01845 Undersecretary