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Home My WebLink AboutBuilding Permit # 6/15/2016 1 BUILDING PERMIT %A'ORTH TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit Nod � ,,. � . � Date Received ��"o��reoW�p'�to Date Issued: 414M -,0RTANT: Applicant must complete all items on this page LOCATION S hkn, 11 Print PROPERTY OWNER V�, Prt�ra 100 Y66r Structure yes Q' MAP PARCEL: ZONING DISTRICT:. Historic District yes Machine Shop Village yes 219 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building — ❑ One family q Addition ❑ Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial I Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other �,Sepfiic% C1 Well ❑ Floodplain ❑ Wetlands ❑ Wafierhed District DESCRIPTION OF WORK TO DE PERFORMT: w. ?t" ,,+ V dentif" tion- Please ype orPrint Clearly OWNER: Name: ' �� / �, Phone: Address: C " w o_.r- L,-( - Contractor N me: 10 V Phone: I Email: e; .. ,. °,.� ° a� ., .f Address: 6 Supervisor's Construction License: ( ,` 1 Exp. Date: Home Improvement License: /6,J6 3 J'3 Exp. Date:! �� ` L ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 3 f 3 FEE: $ � ... , . Check No.: Receipt No.:� r � l 1V®T'E- Persons contracting wik unregistered contractors cls not have„ocrcc°css to 01i Signature of A ent/Owner Signafi�!r ^ o nntr '� { Plans Submitted F1 Plans VAfaived ❑ Certified Plot Plan Stamped Plans F-1 TYPE OF SEWERAGE DISPOSAL[Public Sewer ❑ Taiming/Massage/Body AA 0 SwilDming Pools ❑ wilnm Well,I Tobacco Sales F ood Pa 11 F,,el(aghig/Sales El (�Jl?rivate(septic tan' tc. Permanent Dimapster on Site El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature- COMMENTS ? /,CONSERVATION Reviewed on Signature 'A4 COMMENTS )'k EALTH Reviewed on EA J5 Signature COMMENTS A,-t L�S ') ,1'b � ( e ` � Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision,- —Comments Conservation Decision: Comments Water & Sewer Connection/sLgnature 8, Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPART ENS'; T -,Temp,Dumpster on site yes no,Locatpd,at,124Main Street Fire ) Pak/ signAtdee/date mn el n COMMENTS k t%ORTH Andover Town of 2�o ® - hver, Mass, 0 LAKK A R COC MICMl WICA A. �9 A°RqrIE® PP ,cGs �S R BOARD OF HEALTH LFood/Kitchen Septic System ITu ` BUILDING INSPECTOR ................................................ THIS CERTIFIES THAT .KN . ... ...... . Foundation ... buildins on ... . . .... . ®.................... Rough has permission to erect ""' ' Chimney to be occupied as ® . , ..... . ... ... .... Final provided that the person accepting this permit shall in every respect con rm to the terms of th�ltepationl and on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final EXPIRES I ELECTRICAL INSPECTOR PERMIT I 6 MONTHS Rough UNLESS CONST Service .. ..... . .. ..... ............. Final BUILDWG INSPECTOR GAS INSPECTOR To Oce luired t® Occupy Buildink Rough Final Displayi aConspicuous lace n the Premises — ®® ®t Remove FIRE DEPARTMENT No Lathing o all ToBe Done rBurner Until Inspected an rove y the Building Inspector. Street No. Smoke Det. gEM(�UELInG SPEGIALIS't'S. 975-69'�-520` Keenconstructlon Co.com Zablocki, Ed &Val 60 Windsor Ln. N.Andover, MA 01845 May 20,2016 Contract#5801;Appendix A Existing deck: $16,718 • Remove and dispose of existing deck • Frame deck to code with same footprint as existing • Create two stairways ing and Timbertech Radiance Rail system supply• & install Azek XLM Mahogany deck • Wrap deck in PVC trimboards Finish inside of sunroom:$16,650 Supply&install electric radiant floor heat in entire room Supply&install the floor($5/sq ft allowance) Supply&install insulation to code Supply&install%" blueboard and skimcoat plaster to smooth finish • Supply& install trim on windows and base to match existing Paint walls,ceiling and trim Total Price:$33,368(thirty three thousand three hundred sixty eight dollars) Price does not include cost of permits or repairs to any unusual, unsafe or non-code compliant existing conditions not addressed in this quote. Payment Schedule: $5000 due when existing deck is demolished $5000 due when deck is framed $6000 due when deck is complete $6000 due when electrical is complete $6000 due when trim is complete $5368 due when contracted work is co 7le r Robert Keen 1;ustomer Date Date Page 1 of I P: 978-691-5201 PO Box 935 F: 978-682-3231 N. Andover, MA 01845 HIC#108383 CSL#076691 Sales@KeenConstructionCo.com 53 KEEN CONSTRUCTION CO. �6, 3ox 935 PROPOSAL No 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. GJ A 4C, I 2� `,�OG'/t with the Commonwealth of Massachusetts. Inquiries F— y v\ about registration and status should be made to the Director,Home Improvement Contract Registration,10 V'JJCrY— Lki Park Plaza, Room 5170, Boston, MA 02116 617-973- Q ( 8787 Owners who secure their own construction l Irl�G�2-Ir'. 1 I o I 7 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. 5!2v L2 I(7 MA. H.LC. 108383 46—3783401 > C/S=Customer Supplied S+I=Supply+Install I See Attached Appendix A We hereby submit specifications and estimates for work to be performed and materials to be used: k �� h sw)�� tm SepOQPt,t�f; x > Construction related permits: WORK SCHEDULE Conlr er gill not gin the work or order the materials before the third day following the signing of this Agreement,unless specified here in 'tin . Contr clor will begin the work on or about O (dale).Barring delay caused by circumstances beyond Contractor's control,the work will be completed by 1 (dale).The Owner hereby acknowledges and agrees that the scheduling dales are approximate and that such delays[hat are not avoidable by the Contractor shall n 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 f— 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 Contract ,his subcontractors,employees or agents,is discovered within one year after completion or 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 andlabor-complete in accordance with above specifications,for the sum of: t� Yee 1c31� ,n � IV!(l°P Nf�/I(1,h ��1 j dollars($3�2i3i(' rD i ). Payment to be ade as follows: e/ ($ ) upon signing Contract; ROBERT A. KEEN Name of Contractor/Designated Registrant % ($ ) upocompletion of • PC R,- C� ( I Street Address ($ shall completion of N. ANDOVER, MA 01845 City/State P ($ ) shall be made forthwith upon (978)691-5201 (978)682-3231 completion of work under this contract. Phone Fax Notice: No agreement for home improvement contracting work shall require a Rn&r4Ak'?N o >down payment(advance deposit)of more than one-third of the total contract priceame !S la man 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 Auttleaur4d S106atural equipment,whichever amount is greater. Note:This proposal maybe withdrawn by us it not accepted within 3 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 NOTSIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. [ SignatureDate 'i/4L)/6 Signature Date IMPORTANT INFORMATION ON BACK - - --- -- - J _- TTi - - I 4. --- - - -- - — b' The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 SVS, www.mass.gov1dia -kers' Compensation Insurance Affidavit:Builders/ G ACJTHOItITly,tricians/Plumbers. Wo1 ke TO BE FILED WITH THE PERMIM Please Print Le ibl A licant Information r' Ai �.,� Name(Business/Organization/Individual): Address: 1 �`�— X74+ �� ll 1��1 G f SP one#: C _----- City/State/Zip: Type of project(required): FE employer?Check the appropriate box: Z �, []New construction employer with employees(full and/or part-time).* 8 Remodeling sole proprietor or partnership and have nce require working for in 9 n Demolition apacity.[No workers'comp. self. No workers'comp.insurance required.]t 10 ❑Building addition a homeowner doing all work my [ I willa homeowner and will be hiring contractors to°ensatioonduct n insur nee or are sole11.❑Electrical repairs or additionse that all contractors either have workers'comp12,[]Plumbing repairs or additionsietors with no employees. 13.❑Roof repairs 5❑I am a general contractor and I have hired the sub-contractors listed n ance I n the ached sheet. 14 ❑Other These sub-contractors have employees and have workers'comp. er c- 6.F1 We are a corporation and its officers have exercised their right of exemption equired]MGL c. 152,§1(4),and we have no employees.[No workers'comp. ensation policy information. *�,y applicant that checks box#1 must also fill out the section below showing their workers'comp sheet showing the name of the sub-contractors and state whether or not those entities have I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating suc . Iiadditionalp, olio numbe $Contractors that check this box must attached an employees. If the sub-contractors have employees,they must provide their workers'coin policy er that is providing workers'corrzpensation insurance far»ry employees. Below is the policy andjob site I cnn an employ information. rS I iq J S Insurance Company Name: - Expiration r 99� ( G`�—2 -- � Expiration Date: � � U Policy#or Self-ins.Lic.#: 14 iJ V\ �� n LC City/State/Zip': 4 Job Site Address: Inl 1 } e showing the policy number and expiration date). of the workers compensation policy declaration page Attach a copy a fine u to$1,500.00 Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by P imprisonment,as well as civil penalties in the form to the Office TOP WORK Invoesga ions of the DIA for insura ce 00 a and/or one-year p be forwarded day against the violator.A copy of this statement may coverage verification. I do hereby certify,.'u d the ains a►zdP enalties of per jury that the in provided above is true and correct. Date: Si nature: Phone#: official use only. Do not write in this area,to be completed by city or town official. permit/License# City or Town: Ins ector Issuing Authority(circle one): 1 Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing P 6.Other Phone#: Contact Person: Massachusetts -Department of Public Safety Board of Building Regulations and Standards - -ol-istl ucti1/11 Sullie1 V iSOi � License: CS-076691 ROBERT AKEEN:` ''�• 12 E WATER ST� 1 1 MW North Andover A'A" 0 r 954, � .�rir�>� Expiration Commissioner 08/16/2017 �11P C6............��a��U/i�CCJdCGC�CGd6CCJ ice of Consumer Affairs&Business Regulation E IMPROVEMENT CONTRACTOR egistration: 108383 Type: ',=Yy Expiration gM80)16 Supplement Car KEEN CONSTRUCTION CO ROBERT KEEN 1175 TURNPIKE ST NO.ANDOVER, MA 01845 Undersecretary