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HomeMy WebLinkAboutBuilding Permit # 12/6/2016 ;oFy BUILDING PERMIT oN=�L�o TOWN OF NORTH ANDOVER 10 APPLICATION FUR.PLAN EXAMINATION ' M . Permit No#: l Date Received t'rev rp'y^ SSS-ac�us�� Date Issued: ORTANT:Applicant must complete all items on this page LQCATI(JN Pr int ' PROPERTY OWNER .:- _� _-.._ ht 100 Year Structur® ' yes ". o .._._ 1VIAPPARCEL �` ZONING DISTRICT :. HIstorrc District ye_ n Machine 5hop.Village TYPE OF IMPROVEMENT PROPOSED USE Residential Non-- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units. ❑ Commercial )DRepa€r, replacement 1J Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic it We11 OF b p1pim" 0 We lan 0 VVat rshed District C]UVaferlS�wer. ,,. q. _...:.. - DESCRIPdcc) C5 TION OF WORK TO BE PERFORM D: "A 6 Iden ' atiQ,n- Please Type or Print Clearly OVVNER: Name: i q v Phone: ' k vAddresss J e�cv�.;� Gor�tractor Natne' :v1_ .�'S Phone:_ _ � �`" � Zo Address: O- 3d c)35 5upe.rvisor's Ccanstruetiein License. _.C5��.7���� :: Exp. Date. Horne Irnl?rovrnerif License _ C) 1=xp_ Dater �i7.lr ARCHITECTIENGINEER Phone: Address: Reg_ leo. FEE SCHEDULE.BULDING PERWIT:$12,00 PER$1000.00 OF THE TOTAL ESTIMATED COSTBASED DIV$125,00 PER S.F. °_ ,Total Project Cost: $ (o930 FEE: $ Check No.: Recei� Na,: 71) NOTE: Persons contracting witli unregistered contractors do t av We e o the guaranty fund 5i riafure>af.A :ent/Cwter Si nature o coni ct- r t%ORTI, own of No. b 1t yah ver, Mass, CLAKA . ,Qs0RATED 0C7 U BOARD OF HEALTH Food/Kitchen PE MIT T LD Septic System �kmTHIS CERTIFIES THAT . .. ,. ....,... �„ �1L.. BUILDING INSPECTOR . ..,. Foundation has permission to erect .......................... buildings on .. .�..... .. .. . , . . �. ... ... . .,,..,,..,..,',,. Rough .. . ,.1*ish� 1.�.�til .,IQ.l1!�! ... t �ffx�► to be occupied as .. . ................... ..... ..........,.................... chimney provided that the person accepting this perll 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 apectlia;Alterartion sjand Construction of Buildings in the Town of North Andover. CPLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Kermit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI. T Rough Service BUILDING INSPECTOR Final GAS INSPECTOR 0ecy,pancy 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. surer Street No. Smoke Det. a yr a Or R "IN)MV11 of l c� .t. 1 . nclovera �• Cbdtire Shop'i✓ilQ Mrigglihc>rE7ercitl 4'mnwaytnti4 n 17inMta dsotrr"nio n 1600 C)vt"ood 'sovel wlarrih rwtta,lcrr t t, hl,^ [ll t.v h"7 tor EXCLUSTOT114 Froin Certificate to Alter Celtain alleratiom twe excludedllrcun review Fly°th" hfttehirtrd,5`l�urlr Village Neighbiwhood f"rememmbn Mtri('t E7rrrrrnk,6w ua arx^tarcldnwe tvith the Bylaw ,dpplicrrntsfiar e.aernpt prujeaa nrtert.ill rant theloon below and subuait to Clue l'ominls.eion Chrttlperson fcrrnloct it(n bolow). pg Date: J. _1_.1. l,._ Contact N arae tir.Address- Project cres 1:'r4t cw4:t Address: _.., ....,__.__._ F'rarlatct F;)4a rlfrttr�n (attach aal41tat4ru al lxytt� tlneeded): .._ .. ., ., _... � •� �,�.,� ����.It.,�r „t..,.. C,�„-fir'."o� tl.:'1"� (" � � Y� �_,r' {��� 0 4, �.. h,xctltasaiott From Review FFee ue4ted For: hl 1, Inwrior Alto xions ce'aatdaa oms 6cln4ling,nm nasals,, design fimd duw4 nsia n", EJ 2,Storin tOndows-and+laaarrw�, �t+:rr°e�a wi^ kions And doors, 1),ICa lrkwmv,,w of cxi.*oin,wbstittatc dtaaa,,substituw siding crtsufrstitnte: f S, llc taaatw,al,tla^gaLr rttrcrttt or irrsaP.�llaiir�s rah winrlom g swhil new itdnt(A kild that mv f,rtttcv,and dtsrv:asgraiatx, srsl:ar.t,awi ally simihr to thc exkaing;,; comditi+rn. 4. ktcniov;al,rcldaacc ww or installation of wiadusw and door.tlxt acts„, U 10. Relrlaa¢:cinem ofoligin.,al fabric ew'ittduv"s,ot,(hwls with:u.hslittetc Ll �i,Acca.°°~sora lrud4hn,v's arh dd s;r,tlratot 100 window"or door (chat lno li ,611 alac ttiptatwc faro of flaror Amy. lnu rtaar;il inwgrity^e Alh respcct to Wa,tit:ami tdntd a on aaftk otig;nA Ll G.ICmwv€a6 ,lading, tiwitrclsaws or tltatrs,a, J 7, Altrrutltrtas mast vkih1c•1"aram,rl+aad he H, ldevrattstwoion,saalrwt.atitisallq'siva il,ar in way. CxWr i”"dt 4ip;rt,of 11 art dk strayed hy>hre,wteram or other dt.,idtesr, L! I('h+)ta ala y rzas,aat4•ttnrsm ate,.i tasrna of larraw&d;:sn°h n ¢la urYlr•tidwi N dr igni MAttcrtr O feaaatrass Hutt artat6 thcr within orx yFcar the rrrttf,ter. .(1P7���?.._..:!;., .. �.L;..Rt1,JIP,..,�.Jt�9aIIdN�JJP11'�ll�.o��l/rdlyrtlircnip�q�i �iu(f�1 i ..1�4 rr o��y�Cd✓d/ADn v�im�iri1O ' ..��iii�".�yd��if1G'9'��ln+ar�nrpi sir giii�, NISV IVCOC Pap,1 (Alnent Char l.ir.Peanwsp,"77 Pin"haat,j",r,r-, ,, a a�� rm q ryVvn of' North Andover ts"JM to hine Shop Villein C`IciF�tliborhcrod C olls lva6oll Dim]ict Commission v ., 1600 Osgood Surcoi Nor ih ;lar levo,MA M RT'i For _ON Frorn Certificate to Mier For Items 9, 10 or 11,provide the following ct<>cumenr.eticrn; l'lrutarrlrlrtosa�iara,c caf existiidg doors, vvr'arrlowW s car siclirrl„as applicably., s<rscryarimIA atalnl;C'nt.e ol`prop svel rnatet-irrlv to be tr.sed fist de°vs, windows m.s'Wilig l''tart and eleava"rrrn a/`ger.~rrar.adr°atc°Nuri fire ltrw It Detertnin:#tical: Ab project is deterrnlne'd tea be X exempi LJ crit e.re°mpf f)unr lvvieav by the Alctchirre`shop llillagw Aleig/rCrrurPworl C'unmarvofion Oi,strirat Commission, Projects Mat tyre dd6;11<:+.9.S.rad?l rnttst cunrlrh'w the fll+lrlit;ertr"r7ro fart C'ervt/irrttf,to Alter available,it-om(he Buildin�r,, 1:)cpartmcm and be reviewed leggy the Cr7rrtrrri,50e'n Oeierntit laliun rnrade lav: .4ilnanue Lizetta M. Fennessy Aleighboiltood Conservation Oi.sirirt C"unarrdissiult 11/29/16 Date MSV NC DC Page 2 OnIVkit C ha its I,ir l e rtri ua ?HI I,S[I ca,f„'�z, eon 6iwo Dan Ostiguy 139 Water St. N.Andover, MA 01845 Contract#6006;Appendix A November 3, 2016 Replace four windows: $2850 • Replace existing front three windows and one side window in bathroom with Harvey Classic windows with 5/8" flat grids to match existing, including full screens • Supply& install new interior casing to match • Re-install existing vinyl siding. Price does not include purchasing new siding if needed. Replace front door: $1100 • Supply& install new front door with fiberglass unit to match existing, with peep hole • Install existing hardware in new door Rear Door: $2950 • Remove rear door, including storm door • Remove hardwood flooring as needed • Repair subfloor as needed, re-install existing flooring • Supply & install new door to match existing($400 credit to re-use existing door) • Re-install existing hardware and storm door Side door:$30 • Supply&install new lock set to match existing Total Price:$6930(six thousand nine hundred thirty dollars) Price does not include cost of painting, permits or repairs to any unusual, unsafe or non-code compliant existing conditions not addressed in this quote. PO Box 935 Page 1 of 2 P:978-691-5201 N. Andover, MA 01845 F: 978-682-3231 CSL#076691 Sales@KeenConstructionCo.com WIC#108383 T aeon Cans�rucfion Ca, t:c�mcat��st.tyvc; �r�c_uau%TS 9�8--G97-520'7 KeenConstructicnCo.com Payment Schedule: $1500 due upon signing contract $1500 due when windows are installed $2000 due when rear door is complete $1930 due at completion of contracted work Customer Robert A Keen Bate Date P© Box 935 Page 2 of 2 P: 978-691-5201 N. Andover, MA 01845 I=: 978-682-3231 CSL#076691 Sales@KeenConstructionCo.com HIC#108383 6006 KEEN CONSTRUCTION CO. PROPOSAL PO BOX 935 NORTH ANDOVER, MA01845 Tel:. (978} F91-5201 All home improvement contractors and subcontractors 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 to 1_.1C 0J 1t U `� with the Commonwealth of Massachusetts. inquiries about registration and status should be made to the 4 J 7 V Director, Home Improvement Contract Registration, !L1C(r t� 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787 J C.yA)h, li � i� I 'i Owners who secure their own construction related permits ordeal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c.142A. P O`N'ES _ REGISTRATION NO. EIN NO.Z-15 7— �tc� i 4 r MA.H.I.C. 108383 46—3783401 > GS=Customer Supplied S+I=Supply+Install See Attached Appendix A We hereby submit specifications and estimates for Pic to bG performed and materials to be 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 beer)approved by the Secretary of the l xg five Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided'ryMa%user General Laws,chapter 1GA. Homeowner's Signature _ Contractor's Signature NOTICE:The Signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution initiated by the contractor.The homeowner may initiate alternative dispute resolution even where this section Is not separately signed by the parties. Co['struction Relate Per ts: \ 4 WORK SCHE©UE - '..... Contractor will not begin t w rk or order the materials before the third day following the signing of this Agreement,unless specified here In Fit h C tjjactor will begin the work on or about�n(date.earring delay caused by circumstances beyond Contractor's control,the work will be completed by �,� C1Olate).The Owner hereby acknowle_ges and agrees that the scheduling dates are approx#mate and that such delays that are not avoidable by the Contractor shall not be considered as violatlons 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—__j 4 eel � 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 sub- _ contractors,employees or agents is discovered within one year after completion of any job,including cleanup,the Contractor shall,at his own expense,forthwith remedy, repa1r,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 SPrOpO52 hereby to furnish material and labor-Com plete in accordance with above specifications,for the sum of r 1 �'06 )Ulv 1, dollars .Payment to be made as follows: _ % ($ )upon signing Contract;{A ROBERT A. KEEN . VName of Contractor/DeOgnated Registrant i ` PO SOX 935 % {$ lv,dn?� ?�letSon of Street Address. upon completion of N. ANDOVER, MA 01845 City l State % ($ shall be made forthwith upon (978} 691-5201 {978}6$2-323.1 completion of work under this contract. Ph6n) I 1 moi, EI Fax Notice:No agreement for home improvement contracting work shall require a �Nam\'`\f 5a#e5 e o >dowmpaymont(advance deposit)of more than one-third of the total contract price 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 Authorized Signature materials and equipment,whichever argount j5 er. Note:This proposal may be 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 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. IDO NfQT_SIGN THIS CONTR CT IF THERE ARE ANY BLANK SPACES. Signature =_���A< L.�l � Date Signature bate '.. IMPORTANT INFORMATION ON BACK ► The Commonwealth of Massachusetts Department of Industrial Accidents I. Office of Investigations + j> 600 Washington Street Boston, MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): een > UC, (on Address: D City/State/Zip: t� �lPhone #: 7 0 6 9/ - ��Q Are you an employer? Check the appropriate box: Type of project(required): 1.4 1 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. New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. E] Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance. � required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no 13.n Other employees. [No workers' comp. insurance required.] *tiny 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, tContractors 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: �e r 5 Policy#or Self-ins. Lic. #: ��, } � 999 11 1 '"1 5's I I Expiration Date: � A /I Job Site Address: C�)9 bier Sf City/State/Zip: Attach a copy of the workers' compensation 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. Ido hereby certify urs er Iie p i s and enalties of perjury that the information provided above is true and correct. Si ature: Date: r( j Ir? Phone#: / D — (_o9l y-2-0 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 Cleric 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: P ATE(MMIDDIYYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE `.�� 10147/2016 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(ies)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 NAME°T Barbara McDonough GILBERT INSURANCE AGENCY INC. °NO No�Exil (781)942-2225 C Nuh ADDRESS: -MAIL bmcdonough@gilbertinsurance.com 137 MAIN ST. iNSURER(sJAFFORDINGS9KgRAGE _ W IVAIC# READING MA 01867 INSURERA: TRAVELERS INDEMNITY CO OF AMERICA 25666 INSURED --- INSURERB: KEEN CONSTRUCTION CO INSURERc: INSURER D: PO BOX 935 INSURER E: NORTH ANDOVER MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER. 94268 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. ILT R TYPE OF INSURANCE ADOL SUER POLICY NUMBER POLICY DIIYEYYY POLICY LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE O CLAIMS-MADE OCCUR PREMISES_La occurrence $ RE MED_ EXP(Any one person) $ NIA PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE DMITAPPLIES PER: GENERAL AGGREGATE $ POLICY❑Z a n LOC PRODUCTS-COMPIOP AGG $ OTHER: $ - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ a accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS NIA BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMSAeDE NIA AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY ..._....�._,_......,....,______ ANYPROPRIETORIPARTNERIEXECUTIVE Y I N E.L.EACH ACCIDENT $ 100,0{)0 A OFFICERIMEMBEREXCLUDE( NIA NIA NIA 6HUB999IM58216 10/08/2016 10/08/2017 '.. (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 000,000 NIA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only. Pursuant to Endorsement WC 20 03 06 B, no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of North Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St AUTHORIZED REPRESENTATIVE North Andover MA 01845 Daniel M.Croy,CPCLI,Vice president—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Massachusetts -Department of Public Safety Board of Building Regulations and Standards ate".friiitPiiCiiGii.�]iJ IICI Y1.\IJI License: CS-076691 -l:.'rT.s ROBERT A KEEL`' 'T 12 E WATER ST 1 IMP North Andover 141A 0 Expiration Commissioner 0811612017 n:.....:.....:....:..........._................... ................................. .,.:,,.....:. �>I.8 l(Ialli/IiLr197-luP,CG���o���/�(76JCLc�2.{tJe� Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Z.ype: Supplement Card e`Istraiioa Expiration 10383 08/17/2018 Keen Construatlon Co + Robert Keen; 1175 TurnpikeNo.Andover,MA 01845_ Undersecretary