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Home My WebLink AboutBuilding Permit # 5/23/2016 Check No.: . � ----------------- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ TanniuWMassagc/Body Art ❑ Swimming Pools L1 Well ❑ Tobacco Sales ❑ Food Packaging/Sales 0 Private(septic tank, etc. xPermanent Dwnpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN -OFF - U FORM ❑ PLANNING & DEVELOPMENT Reviewed OJ�M&16 Signature COMMENTS (KOrAm �09)y)� Revie wed on CONSERVATION Siqnature COMMENTS / HEALTH Reviewed o Si nature \COMMENTS Zo P, ing 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 no, -Xi Lo, da d,at,,124 Main Street Fire,Depp�trn"eh't signa"tui6/date COMMENTS vt®RTiLi Town ofeAndover 0 0 ...... ...... No. i - C® ' aAoce . ver SSS' 11(A4 ;- 3 . 204P cocwicroew.c. SATE® BOARD OF HEALTH Food/Kitchen P E Septic System T e aka. LD THIS CERTIFIES THATY- IT ® BUILDING INSPECTOR ....................... ..... .... .. ......... em ...........t!4 .................... has permission to erect ......... buildings on . Foundation ® ® Rough g to be occupied as .. .. ... . .. ....... .... ... .. ...... .... .. ... ........................ chimney provided that the person accepting this permit shall in very respect conform to the terms 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 EXPIRESPERMIT IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CON STRU CTION7 STARTS Rough ..............: ...� ......................... Service ', Final ., ` BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do NotRemove Final Lathing r Dry Wall To Be Done FIRE DEPARTMENT Until S ec a and Approvedthe Building Inspector. Burner Street No. Smoke Det. ermoot=�_tnc sPt:ctnt_ts•rs 978-697-5207 Ke enConstructionCo.com Pashayan, Dave and Betsey 25 Cedar Ln. N.Andover, MA 01845 Contract#5581;Appendix A May 1, 2016 Replace front porch: ® Frame 6'x 7' deck in place of existing deck(which homeowner will remove) ® Dig two holes as needed and install pre-cast cement footings ® Frame new 6'wide stairs, landing on exposed aggregate walkway ® Supply& install PVC trim and lattice o Supply& install Azek XLM Slate Gray PVC decking with color matched plugged screws ® Supply& install white Azek Premier rail system with white balusters and copper post caps Total Price:$6684(six thousand six hundred eighty-four dollars) Price does not include cost of permits, demo or repairs to any unusual, unsafe or non-code compliant existing conditions not addressed in this contract. Payment Schedule:$1000.00 due upon signing contract $1500.00 due when holes are dug(plus permit fee) $2500.00 due when framing is done $1684.00 due when complete Customer Robert Keen Date I I Date PO Box 935 Page 1 of 1 P: 978-691-5201 N. Andover, MA 01845 F: 978-682-3231 CSL#076691 Sales@KeenConstructionCo.com H I C#108383 55 . a KEEN CONSTRUCTION0.�v 935 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 bit,}-C k, ��P je4( 1��,J'��y�n with the Commonwealth of Massachusetts. Inquiries Tf about registration and status should be made to the i ( Director,Home Improvement Contract Registration,10 L {�r n Park Plaza, Room 5170, Boston, MA 02116 617.973- 8787 Owners who secure their own construction related permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c.142A. PHONE DATE REGISTRATION NO, EIN NO. S,I (� MA. H.I.C. 108383 46—3783401 > C/S=Customer Supplied S+I=Supply+Install See Attached Appendix A We hereby submit specifications and estimates for work to be performed and ma(eedals to be used: I -c"+ �(-)i-C_�) peli cI t x Construction related permits: WORK SCHE ULE Comm orb gin the work or order the maledals before the third day following the signing of this Agreement,unless specified he in riling o tractor will begin the work on or about J' (date). Barring delay caused by circumstances beyond Conlractots control,the work will be completed by 216 � (dale) 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. WARRANTY t�e�l 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 workmanship.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 accordance with above specifications,for the sum of 'Div — dollars($ (: 99,CSO ), Payment to bq made as follows: % ($ ) upon signing ontract; ROBERT A.KEEN // Name of contractor/Designated Registr tt ($ p C PllaWh df 1'17-5-T14RN UE—SST. Street Address ($ ) p n completion of N. ANDOVER, MA 01845 �/ City/Stale shall be made forthwith upon (978)691-5201 (978)682-3231 ($ ) completion of work under this contract. Phojr5 Fax Notice: No agreement for home improvement contracting work shall require a kO C >down payment(advance deposit)of more than one-third of the total contract price Name° Ile man V or the total amount of all deposits or payments which the contractor must make,in advance,to order and/or otherwise obtain delivery of special order materials and Authoiizea SighEltlurd equipment,whichever amount Is gfeatef. Note:This proposal may be withdrawn by us if not accepted within days. Acceptance Of Proposal-1 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. an ellation must be done in writing. NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. l Signature Date I Signalure Date IMPORTANT INFORMATION ON BACK liltN- North Andover MIMAP May 2, 2016 r I' �•1// iii/ � � '' ��',1C16:A"=0146 f y, -61iCEDAFkLIV / I 106.A-1ip36 w i i j a 6 f! u�� 11)6 Ri-OC151 1a5.0-OU1� AJ � Q MVPC Bo Interstates Horizontal Daturn:MA Stateplane Coordinate System,Datum NAD83, I Meters Data Sources:The data for this map was produced by Merrimack SR NRTl — 10y Valley Planning Commission(MVPC)using data provided by the Town of Roads 0� t`�D , q� North Andover.Additional data provided by the Executive Office of < 6 r 4 Environmental Affairs/MassGIS.The Information depicted on this map is two-Easements '� ♦d O .}, " G for planning purposes only.It may not be adequate for legal boundary Parcels O definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER �" 21 MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING ,K * THE ACCURACY"COMPLETENESS,RELIABILITY,OR SUITABILITY OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT rF °o y°• ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION 43,SNCHWS 1"=52ft ~"(V) ° The Commonwealth of Massachusetts F Department of Industrial Accidents h ..r 1 Congress Street,Suite 100 Boston,MA 02114-2017 wwlv.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/E lectricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITI'. Applicant Information Please Print Legibly Name (Business/Organization/Individual): 114-en �C VI S �lJ C C7 Address: Ct, a n x 93 i�,l lqn C-•"Ne Ir l �� G igP one#:-9-)Z— (c, City/State/Zip: Are you an employer?Check the appropriate box: Type of project(required): 1.[Z I am a employer with 2 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, DDemolition In I am a homeowner doing all work myself[No workers'comp.insurance required.]t 10 ❑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.❑Electrical repairs or additions proprietors with no employees. 12,0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.F]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. $Contractors 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 insurancefor my employees. Below is the policy and job site information. Insurance Company Name: (mc,yl✓ t lv f 5 lo-5 — Policy#or Self-ins.Lic.9:6 No iJ — 99/ 1 M J`9 2- " 15 Expiration Date:4h,, ,,d i1Ci /State/Zi �/.Job Site Address: 1/ ( � ( "? tY pAttach a copy of the workers' compensation policy declaration page(showing the policy nuexpiration' ate). 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. 7 I do hereby certify u rd r le p and penalties ofperjury that the information provided above is true and correct. signature: Date: Phone# � Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# LLBoard ority(circle one): ealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector on: Phone#: ACCM0CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 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 CO E.C Barbara McDonough Gilbert Insurance Agency, Inc. PHONE (781)942-2225 F o:(701)942-2226 137 Main Street ADRIEss :bmcdonough@gilbertinsurance.corn INSURER(S)AFFORDING COVERAGE MAIC# Reading MA 01867-3922 INSURERA Norfolk & Dedham Insurance 23965 INSURED INSURERB:Safety Insurance CompanV 39454 Keen Construction Company INSURER C-.Travelers Ins. Co. 0031 483 Chickering Road INSURERD: INSURER E: North Andover MA 01845 INSURER F: 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. INTR TYPE OF INSURANCE DD POLICY NUMBER ILISUBR P1IM(DDMYY) IMYEFF POLICY EXP YYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMSAIADE XOOCCUR PREMISES En occurrence $ 100,000 ND-P-010078/000 3/13/2015 3/13/2016 'MED EXP(Any oneperson) $ 5,000 PERSONAL 3 ADV INJURY $ 1,000,000 GEHL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY O JELOC PRODUCTS-COMPIOP AGO $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGE MI e eccid $ 1,000,000 enl B ANY AUTO BODILY INJURY(Par person) $ ALL OWNED X SCHEDULED 6228807 CON O1 5/23/2015 5 23 2016 BODILY INJURY Per acckienl $ AUTOSOW.AUTOS / / ( ) X HIRED AUTOS X AUTOS ED PROPERTY DAMAGEpe �Id $ Undadnsured molodst $ 100,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS,MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION �TA AND EMPLOYERS'LIABILITY YIN TD EIER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEEMBER EXCLUOEO7 NIA E.L.EACH ACCIDENT $ 100,000 RaIEl C (Mandatory In NH) 6HUB-999IM58-2-15 10/8/2015 10/8/2016 E.L.DISEASE-EA EMPLOYEE $ 100,000 IIee,desaiba under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION (978)623-8320 SHOULDANY 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 INS025/20u0n Massachusetts-Department of Public Safety Board of Building Regulations and Standards Cllll\tl 11 111 l/11 JVD/GI V111/1 �� License: CS-076691 ROBERT A KEEN-` ' 12 E W ATER ST R North Andover KLA 0 i 954, :31111 Expiration Commissioner 08/16/2017 ��e�o-»trua�rcuecilf�a�C�/laavcce�rc�eL�i ice of Consumer Affairs&Business Regulation E IMPROVEMENT CONTRACTOR eglstratlon�r08383_: Type; Expiration X8/18/2016 Supplement Car KEEN CONSTRUCTIQN;CO ROBERT KEEN 1175 TURNPIKE STS _ A NO.ANDOVER, MA 01845 Undersecretary