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Building Permit #085-2017 - 101 DUNCAN DRIVE 7/26/2016 (3)
BUILDING PERMIT NORry w- 0��. LED TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 7� L IC/ 4 1 Permit No#: G/�- Date Received gSSACHUs�t Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION f 1, t 1V1C _b(—I PROPERTY OWNER c, d h '6 rite, T o Print (J 100 Year Structure yes no MAP PARCEL:ZONING DISTRICT: Historic District yes o Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building 0 One family ❑Addition 0 Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other .may.,- -, Y ;€� . . . � f ,: a sir DESCRIPTION OF WORK TO BE PERFORMED: R,O 0.ct WcG , Identification- Please Type or Print Clearly OWNER: Name: 0� b V\ Phone: Address: In V D ContractorName: G o Phone: Email: <n es -C— Address: r Supervisor's Construction License: 65 —0766 91 Exp. Date: X'7 Home Improvement License: (©8 353 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED N$125.00 PER S.F. Total Project Cost: $ 4 FEE: $ Check No.: Receipt No.: -3060/ NOTE: Persons contActing with unregistered c��orntractors do not have access to th r ty nd 7. 1;:2"�..Y _r..f ! Y F-4 ~vr••*' '`R}, NORTH Town of � Andover 1p h ver, Mass, 04 2 [OC NIC CHI Nl WICK � S U BOARD OF HEALTH Food/Kitchen PE LD Septic System THIS CERTIFIES THAT ... •. W. ....... BUILDING INSPECTOR has permission to erect buildings on ���. .1,�.!�/..�,r /.V... • Foundation .......................... ..... .. .. ..... ..... ... ............. .................................................... Rough to be occupied as .. ....!� . �.... . .�....��'�. 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 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONS TIO Rough Service ... .. . ......... ....... ..... Final BUIL INSPE OR 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. 6038 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 I specifically exempt from registration by Provisions of Chapter 142A of the general laws, must be registered Submitted to: Ct 1��� k ��'� ,/ I r ! 11/l with the Commonwealth of Massachusetts. Inquiries 4r v about registration and status should be made to the Director, Home Improvement Contract Registration, 0 , t 10 Park Plaza, Room 5170, Boston, MA 02116 617-973-8787 1`I ��` J ` IC jl� `- i Vii'i .i' 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 p DATE REGISTRATION NO. EIN NO. 2 LJ In 1 / Z J ' I L^ 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 materials to be used: f� 1 Jif 1i� (AI X ` .. 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 FKecutive,pffice of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as pWv ,,,J'ssacFµtsp--is General Laws,chapter 142A. / G /�f HomeoGv er's Ignatui a 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. Construction Related Permits: WORK SCHEDULE Contractor will not beg'r14Pes or ouyrder the materials before the third day following the signing of this Agreement,unless specified here in wr';in t=will begin the work on or about_ r 5te).Barring delay caused by circumstances beyond Contractor's control,the work will be completed by G (4i e.The Owner hereby acknowlednd agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor sh II not a 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 t^'" following completion and shall comply with the requirements of this Agreement.In the event any defect in workmanship or materials,or damage cau ed 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, 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 ir)accordance with above specifi tions,for the sum of: .J. 1 c J. 11 'Ic,`J �`I C.) — do l� V llars(E /• 1. Payment to be made as follows: % (E )upon signing Contract; ROBERT A. KEEN Name of Contractor/Designated Registrant r l I PO BOX 935 %l($ t I.' pletiono , Street Address upon completion of N. ANDOVER, MA 01845 1 City/State % ($ )shall be made forthwith upon (978)691-5201 (978)682-3231 completion of work under this contract. Phom 1 Fax 1i Notice:No agreement for home improvement contracting work shall require a >down payment(advance deposit)of more than one-third of the total contract Name of SalesmPAt rice or the total amount of all deposits or payments which the contractor must —7 make, in advance,to order and/or otherwise obtain delivery of special order Authorized Signature materials and equipment,whichever amount is greater. 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 d a ter the date of this transaction.Cancellation must be done in writing. (//, . DO NOT SIGN THIS CONTRACT IF THERE AREA Y BLANK SP.ACES Signature " �/� Date Signature C_L '`� - Date' 1 IMPORTANT INFORMATION ON BACK ► e ons -it, onst r— WFAC30EUMC 8- KeeCructionCo.com7 � 7 D'Attorre, Ralph &Jen 101 Duncan Dr. N.Andover, MA 01845 Contract#6038;Appendix A July 13, 2016 Remove interior walls: • Remove approx. 17'of center load wall. Consult with engineer and provide stamped drawing for proper support of second floor and roof.Supply& install a W8-18 steel I-beam per drawings. • Create approx. 55" half wall from exterior wall between dining room and living room, and create a decorative and supportive square column to support one end of beam spanning to basement stair wall.Total clear span will be approximately 17'6". • Remove partition wall between foyer and living room and approximately 6'of partition wall between dining room and kitchen. • Remove flooring in foyer and install approx. 3'x 5'area of tile flooring($5/sq ft material allowance) • Supply& install six recessed LED light fixtures in living room and TV room ($1500 allowance per room) • Remove and relocate electrical wires as needed ($1000 total electrical allowance outside of lighting) • Patch walls and ceiling as needed with smooth skimcoat plaster on walls,texture to match (as close as possible) • Supply& install trim to match existing • Paint walls,ceiling and trim in foyer, living room, dining room and kitchen as needed ($2500 allowance) • Supply&install flooring to match existing in foyer(approx. 50 sq ft) • Sand and seal flooring in foyer, living room, dining room and kitchen (three coat, oil-based finish) Total Price:$16, 700(sixteen thousand seven hundred dollars) Price does not include cost of permits 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 een f C0j3J'ti"tfC60n CD:, REMUDELI/VC: SPECIALISTS 978-697-520 7 Keen ConstructionCo.com Payment Schedule:$1000 due upon signing contract $3000 due the first day of work $3000 due when the beam is installed $3000 due when plaster is complete $3000 due when hardwood flooring is repaired $3700 due at completion of contracted work � Jp ,p f Gusto er Robert Keen -7 L13Z 14 -7//,3 )) (o 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 HIC#108383 yt c� ttt DWG.No. S.1 NEW W 8X18 BEAM NEW 1/4"FITTEDSTIFFENER PLATE EACH SIDE OF WEB 3/16 1/8 > a NEW L2X2X1/4X 21/2"LONG z NEW 1/4"A36 STEEL PLATE X 3"WIDE s NEW 112"BOLT t a � 2 3 S.1 S.1 NEW 4X6 POST DOWN 3/16 53/4"PLATE SPACING & s NEW 4X6 POST d v n CONNECTION DETAIL s NEW W 8X18 BEAM NEW 4 X 6 POST DOWN new 112 wall to post o 8 g� CONTINUOUS 2X6 @ TOP AND BOTTOM a OF BEAM WITH 1/2"BOLTS STAGGERED x o LEFT AND RIGHT @ 32"O.C. 0 8 n U NEW CONTINUOUS 2X6 n 112"BOLTS STAGGERED NEW W 8X18 BEAM LEFT AND RIGHT @ 32"O.C. PARTIAL SECOND FLOOR FRAMING m rw1 PLAN ?l BEAM DETAIL o W 1/4"=1'-0" 1 1/2" �=1'-0" z 0 d s z n z w `O / YY �v The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street r Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0bly Name (Business/Organization/Individual): V_Oeo 4�;S'l CJN c Address: �0 BO x 93 5 City/State/Zip: n Tq5 Phone #: 57F- 691— 5zd / Are you an employer? Check the appropriate box: Type of project(required): I.[N I am a employer with Z 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. E] 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' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance p• required.] 5. ❑ We are a corporation and its 10.El 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 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: Policy#or Self-ins. Lic.#: Q ~ 992 1 M5? — 2- —15 Expiration Date: &—h Job Site Address: b(wcati Dr City/State/Zip: 64�c, M 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. I do hereby certify un e t pain d penalties of perjury that the information provided above is true and correct. Signature: �j_27- Date: :2 112—6 1/1 Phone#: 7� pp `— to 91 ' 5 2_6 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#: ACORD CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDO/YYYY) `.rte 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(le t)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). PROWLER Barbara McDonough Gilbert Insurance Agency, Inc. PHONE (781)942-2225 Fax o:(Alc No (781)942-2226 137 Main StreetRIE .bmcdonough8gilbertinsurance.com INSURERIS)AFFORDING COVERAGE NAIC M Reading MA 04867-3922 INSURERAVorfclk 6 Dedham Insurance 23965 INSURED INISURERB:Safetv Insurance Company 39454 Keen Construction Company INSURERCTravelers Ins. Co. 0031 483 Chickering Road INSURER D: 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. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP im 2M im POLICY NUMBER LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A CLAIMS-MADE ❑X OCCUR DAMAGE To $ 100,000 ND-P-010078/000 3/13/2015 3/19/2016 'MED EXP(Any one ,son $ 5,000 PERSONAL S ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X OTHER: JECT LOC PRODUCTS-COMP/OP AGO $ 2,000,000 OTHER: S AUTOMOBILE LIABILITY $ 1,000,000 B ANY AUTO BODILY INJURY(Parperson) $ ALL OWNED SCHEDULED AUTOS X AUTOS 6228807 COM Ol 5/29/2015 5/29/2016 BODILY INJURY(Per eookler* y X HIRED AUTOS X AUTOS PROPERTY DAMAGE fPer accident) $ Underinsured motorld $ 100,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LUB C".-MADE AGGREGATE S DED RETENTION 11S WORKERS COMPENSATION AND Fd1PLOYERS'LIABILITY YIN EORTH ANY PROPRIEfORIPARTNER/FXECUTIVE E.L.EACH-ACCIDENT O OFFICERIMEMBER EXCLUDED? NIAS 100 000 (Mandatory In NH) 6MM-9991MSS-2-15 10/5/2015 10/8/2016 E.L.DISEASE-FA EMPLOYES 100 000 5 es,deaonbe under DESCRIPTION OF OPERATIONS b.1— E.L.DISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(ACORD 101,Addhional Remarks Schedule,may be attached if 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 tmuotl Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-076691 ROBERT A KEEN 12 E WATER ST< r North Andover 0 y V yb1a� JI'lQ Expiration Commissioner 08116/2017 �e�arrUr�wracaeull�a�vaGaaaac/uutelYi V=-= ice of Consumer Affairs&Business Regulation b E IMPROVEMENT CONTRACTOR istration:- 9 a- , 85='="" Type: Expiratio,#W-, �n i._., j,.. 1•y Supplement Car KEEN CONSTRUCTI,Q7 y ROBERT KEENF_: ,%- 1175 TURNPIKE ST r NO.ANDOVER, MA 01845 Undersecretary