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HomeMy WebLinkAboutBuilding Permit # 7/26/2016 NORr�r ,� BUILDING 136RMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION * h Permit No#: W Date Received sc;Aust�y Date Issued: LT, IM ORTANT: Applicant must complete all items on this page LOCATION PROPERTY OWNER_,-��� Print 900 Year Structure yes %no MAP 1y PARCEL: 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 ❑Alteration No. of units: ❑ Commercial Repair, replacement ❑Assessory Bldg [I Others: ❑ Demolition ❑ Other DES RI TION OF WORK TQ E PERFORMED: Identifieati n- PI a e Type or -int Clearly OWNER. Name; Cc } Phone: Address: Contractor N me: i /C tf (.Gphone: Email: n S J� Address: © C:::� A I ; Supervisor's Construction License: C6— (-)76691 Exp. Date:_ 6(, /1 -7 Horne Improvement License: Exp. Date: r$ ARCH ITECTIENGINEER Phone: Address: Reg, No. FEE SCHEDULE:BULDING PERMIT:$12A0 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ r7 FEE: $ Check No.: 11h Receipt No.: zb NOTE: Persons contr cling Ivith unregistereri contractors do not have access to t ie ar r1 a d y is NORTH own of ndover o 0 No. O _ h ver Mass u s COCNIS Nl WICK ��S�RATEP PPa,`,�5 U BOARD OF HEALTH PER LD Food/Kitchen Septic System Ll TTHIS CERTIFIES THAT .................................�..� ....,��... �...,....... ............ .. BUILDING INSPECTOR has permission to erect...11-I&CO3 .... buildings on . .... .5. ............... .. . W.., Foundation p a Rough to be occupied as ...., .....f.-C. ........................................................ 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 G MONTHS ELECTRICAL INSPECTOR UNLESS CONST TIO Rough Service .. ....... ...... Final BUILDIN INSP TOR GASINSPECTOR Occupancy Permit Required_to Occupy�uildin 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. 6039 KEEN CONSTRUCTION CO. PROPOSAL PO BOX 935 NORTH ANDOVER; MA 01845 Tel:{978)691-5201 All home improvement contractors.and.subcontractors engaged in home improvement contracting, unless Fax: (978) 682-3231 specifically exempt from registration by Provisions of j� Chapter 142A of the general laws, must be registered Submitted to: 17 it n ' Pee � with the Commonwealth of Massachusetts. inquiries Ct� about registration and status should be made to the Director, Home Improvement Contract Registration, 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-6787 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 - - DAT r REGtSTRAVON NO. EIN NO. 7�2 Ca I r MA,H.I.C. 108383 46—3783401 ] CIS=Customer Supplied S+ I Supply+Install See Attached Appendix A We hereby submit specifications and estimates for work to be performed and materials to he used: The contractor and the homeowner hereby mutually agree that in the event.the contractor has a dispute concerning this contract,the contractor may submit the dispute to a private arbitration firm which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulation and the consumer shall be required too submit to such arbitration as provided In/ assac�psetts General Laws,chapter 142A. Homeowner's Signature - Contractor's Signature NOTICE:The Signatures of the parties above apply only to the agreement of the parties to aAernative dispute resolution initiated by the contractor.The homeowner may Initiate alternative dispute resolution even where this section is not separately signed by the parties. Constructlon Related Permits: - WORK SCHEUVLE. - - Contractorwill not b I w or order the materials before the third day following the signing of this Agreement,unless specified here i I 1g C actor will begin the work on or about (date).Barring delay caused by circumstances beyond Contractor's control,the work will be completed by datej.The Owner hereby acknawle ges nd 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 o 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 damage caul d by the contra workmanship or materials,of ctor,his sub- contractors,employees or agents Is discovered within one year after completion of any job,Including deanup,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 hereb o tfurnish material and labor-complete in accordance wt h above sped#€cat'onsr-for the-sum of: v'JE v3 r -lam c C.0 w l f'i,'� d{Ilars{� �� ]? /!— Payment to be Made as follows: % ($_)upon signing Contract; ROBERTA. KEEN Name of Contractor/Designated Registrant - •� i t PO BOX 935 {$ ) b (fo i�S tion o Street Address . i N. ANDOVER, MA 018451 upon completion of City!State 4 )shall be made forthwith upon (978) 691-5201 . (978)682-3231 completion of work under this contract. phon Fax w/} �f Notice:No agreement for home'smprovement contracting work shall require a ]down payment(advance deposit)of more than one-third of the total contract Name of Salec n price or the total amount of ail deposits or payments which the contractor must make,in advance,to order anal/or otherwise obtain delivery of special order Authori ed Signature materlals and equipment,whichever amoynj is greater, Note:This proposal may be withdrawn by us If not accepted w1thin_day5. Acceptance of Proposal -I have read both sides of this document and all attached documents and accept the prices,specifications and conditlons.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 outline 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 BI,ANI SPACES � h /2./ .�7 I'� - SI nature,'!ii Date 7, Signatufe_� - Date 9 rte= IMPORTANT INFORMATION ON BACK I• Ggnszrru�i7��;Co., REMC]1l FLll'IG SPECIALISTS KeenConstructionCo.Com QUOTE Peck,Alan & Cynthia 225 Haymeadow Rd. N.Andover, MA 01845 Contract 6039;Appendix A July 20, 2016 Remodel kitchen: • Remove and dispose of existing kitchen cabinets, counters, backsplash and floor • Remove and dispose of existing pantry closet walls • Update electrical as needed, installing undercabinet light wiring and switching ($750 extra to install lights),a new sub-panel and 10-12 LED recessed light fixtures ($3250 total electrical allowance) • Remove and install customer supplied plumbing fixtures and appliances ($2500 parts and labor allowance) • Patch walls and ceiling as needed with skimcoat plaster. Ceiling texture will be matched as close as possible • Supply& install approx. 290 sq ft of 2 A" Oak prefinished flooring in kitchen and hall ($1000 additional to install flooring in laundry) • Install customer supplied cabinets and.related trim. • Install customer supplied appliances, including vent for range hood. • Supply& install the backsplash ($300 material allowance) Total Price: $22,724(twenty two thousand seven hundred twenty four dollars) Price does not include cost of permits, painting, cabinets,counters, appliances, plumbing fixtures or repairs to any unusual, unsafe or non-code compliant existing conditions not addressed in this contract. PO Box 935 Page 1 of 2 P: 978-691-5201 N. Andover, MA 01845 F: 978-682-3231 CSL.#076691 Sales@KeenConstructionCo.com HIC #108383 i IFttJV�UUF1.k/11G SNL•CIl"-11, 5'Tti X3'78 69�- 20'1 Kee"Constructiooco.com Payment Schedule: $1000 due upon signing contract $4000 due the first day of work(plus permit fees) $4500 due when rough electrical and plumbing is complete $4500 due when plaster is complete $4500 due when cabinets are installed $4224 due at completion of contracted work Customer Robert A Keen 7 ZVza r 6 -- Date Date PO Box 935 Page 2 of 2 P: 978-691-5201 N. Andover, MA 01845 F: 978-682-3231 CSL#076691 Sales@KeenConstructionCo.com H1C#108383 1081 76" 158° SF01S3X30 WB1 OS(300)5434 CABICO UNIQUE - BEADED INSET ' --------#3.0.0--DOORSTYl.E---SiMU-LATIYD MAPLE INJE IOR� STANDARD BOX CONSTRUCTION NANTUCKET ON MAPLE- 5P DEEP DRAWEE S _ CH 96" HH 90" DM/SHA01 S8 SOFFIT W/BEAD bN BOTTOM DM/CRW24S8 CROWN i DM/TOB01S8 TOEKICK DM/ACT02S8 LIGHT RAIL, REF- SAMSUNG RF23J9011 SR RANGE- SAMSUNG NE58H9970W5 4-ADJUSTABLE SHELF MW- KITCHENAID KBMS1454OSS =-=---------- 5=(5) ROLL OUTS HOOD-ZEPHYR MODENA 30 6 D30S7X12 w 7-D30S7X12X314 1-OP05 -PREP FOR GLASS ' ' 2-OP12 -TILT OUT 3-OP03 - (1) ROLL OUTZ- WA10S(300)5418 DV09S41/2X60/ I /� `SF01 S3X96 ���i 9f 00-7 36B WKD2736 j N 1 - 27-jL; A 18w 4 27" 25" r-24-5 ---50 3 , :, V 8 ■r 6 2a 8212 ,ORI GENOVESE This is an original design and must Designed: 6/6/2016 JACKSON not be released or copied unless Printed: 6/15/2016 KITCHEN applicable fee has been paid or job DESIGNS order placed. All JDrawing #: 1 INo Scale. s The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 ti www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers „ Applicant Information Please„Print Legibly,•,,,• Name(Business/Organization/Individual): C eo Address: 9 �J City/State/Zip: n Phone#: 572- X091 5Z6 / Are you an employer? Check the appropriate box: Type of project(required): 1. I am a employer with_ 2__ 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' insurance.t 9• FJ Building addition [No workers comp.comp. insurance required.]ui5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions q ] officers have exercised their 11. Plumbing repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL ❑ myself. [No workers comp. g p p 12,❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp, insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'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. $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 insurance for my employees. Below is the policy and,job site information, Insurance Company Name: le r- Policy#or Self-ins. Lie.#:_ �� V J"1 - z " � Expiration Date: :02� 4 Job Site Address: Z Ct�Clt til City/State/Zip: ✓ /YIITCj Attach a copy of the workers' com ensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereby certify un t pain d penalties of perjury that the information provided a ave i716 a and correct. Signature: / Date: -2 �� (o Phone#: 9 7 z. 1 — Z c� 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#: CERTIFICATE OF LIABILITY INSURANCE DArEIMMCDIYYYYI 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 ceriltEcate holder Is an ADDITLONAL INSURED,the pcilcy(€es)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an ondorsement. A statement on this certificate does not confer rights to the certiflcate holder In lieu of such endorsement(s). PRODUCER LI ° Barbara McDonough Gilbert Insurance.Agency, Ina, °N (781)942-2225 A o,(781)942-2226 137 Main Street DDIE ,bMadonough@gilbertinsurance.com INSURERS AFFORDING COVERAGE NAIC/ Reading MA 01867-9922 €NSURERA3.orfolk 6 Dedham Insurance 23965 INSURED InsuRen a.-Safety Insurance CompanV 39454 Keen Construction Company IsuRSRcTravelers Ina. Co. 0031 483 Chickering Road INSURER D: iNSURERB North Andover MA 01.845 INSURE P; COVERAGES CERTIFICATE NUMBER CL1552101779 REVISION NUMBER. THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FORE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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. INORADDLIS1.111F -- Lid TYPE Or INSURANCE INab wvn POLICY NUMBER POLI43YEFPPOUCY110 LIMITS X COMMERCIAL GENERAL LIABILITY UuRmn =20= EACH OCCURRENCE $ 1,000,000 ACLAIMS4AADE O OGGUR E ES o- a ca s 100,000 lm-P-010078/000 3/13/2015 3/13/2016 'MED ERP An one ;so ; 3,000 PERSONAL&ADV€NJURY $ 1,000,000 GENTA00RE0ATE LIMiTAPPUES PER: GENr;M AGGREGATE ; 2,000,000 X POLICY El 30-T COC PRODUOTS-CCMLA PAG() $ 2,000,000 OTHER: y AUTOMOBILE LIABILITY S S 1,000,000 ,B ANYAUTO BODILY INJURY For person) $ ALL OWNEDSOHEIX7LED AUTOS X AUTOS 6225007 CON 01 5/23/2015 5/23/2016 BODILY INJURY(Per W.np $ X HIRED AUTOS X ALYTO MED PROPER DAMAG ; Underinsured mo€sdd $ 100,0 00 UMBRELLA LIAR OCCUR EACH OCOLIRRSNCE EXCESS LLAB CLAIMS-MADE AGGREGATE $ DED I I R NTION $ WORKERS COMPENSATION AND EA I'LOYERV LIABILITY Y)N STATUTE.J.. ER ANY PROPRIETCRJPAftTNVJVFXE'CVTIVE £.L.E4CH ACCIDENT $ 100 000 0WICENIMEMBER EXCLUDED? 0 NIA tM+rydatoly lB NN] 66if6-4991M5B-2-Itl 10/0/2015 10/8/2016E.E.DI5EA9E-EA EMPLOYE S 100,000 Syes de.orlbe under DESGIRIPTIDN OP OPE RATIONS 1,e1c4f E.L.OrSEASE-POLtry CIMIT 500,000, PFFCRIPTIONOFOPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addillond Ramuli.S b*dut.,maybe attached It M—tpac.I.required) CERTIFICATE HOLDER CANCELLATION (978)623.8320 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRAT€ON DATE THEREOF, NOTICE WILL. BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE M Gilbert, CIC/BARBAR Q)1988-2014 ACORD CORPORATION.All rights reserved, ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(2014011 oMassachusetts -Department PPublic Safety Board of Building Regulations and Standards CnnstrTactian Saupei-visnr License, CS-076691 "l,r i.cM . ROBERT AiKEE11J�` "� 22 E WATER ST� IMI -i, North Andover MA 0 c _f Expiration Commissioner 0$11612017 VfdU {(6IY1?JEOlICIJCClG1�OLUl,GC64J �j. lee of Consumer Affairs&Business/Regulation E IMPROVElV RNT CONTRACTOR gistration s Type: 30 &3=. Ex irati ` .. � A 4tl .w_ Supplement Cal KEEN CONSTRUCTI6'( ROBERT KEEN 1175 TURNPIKE ST NO.ANDOVER, MA 01845 Undersecretary 1 e F E i i i