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Building Permit #232 - 11 OXFORD STREET 9/26/2006
TOWN OF NORTH ANDOVER NORTh APPLICATION FOR PLAN EXAMINATION 0`4��•0 o •. �, � ! Permit NO: S-t?-'" Date Received ( ,g&�� _ Date Issued. �SS�eHus�� IMPORTANT: Applicant Must complete all items on this page LOC:\TION f/ © X --L- S C Print PROPERTY W�ER "c C . v2�L�-z _ Print MAP NO. PARCEL. 'L ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family _ ,addition - Two or more family - Industrial C Alteration No. of units: Repair, replacement Assessory Bldg Commercial Demolition Moving(relocation) Other Others: Foundation only DESCRIPTIO"F WORK TO BE PREF RMED ``<<<rz mnd0, z P P /e o.ti. `C& ogtk Identification Please Type or Print Clearly) OWNER: Name: �'` t� 7%.;a p I-r-, , Phone: 9��9 0�1 Z •'�I q y Address: CONTRACTOR Name: ���� tj Co 'i5 f rL.J c' : , Ph CONTRACTOR bg'l-640 t address: Z L Ili! w : 4 L/ G Supervisor's Construction License: J 2 Lt Exp. Date: 73 —21 -coS ilon-ic Improlcmcrit License: l D a ✓u� EYp. Date: SS —I� ARCHITECT• EN ` Name: Phone: Address: - RZcg. No. FEE SCHEDULE:BLZDING PERMIT.-MOO PER S12/�0 00 OF THE TOTAL EST1.Y/ATED COST BASED OA S125.00 PER S.F. Total Project Cost :S /C _ & �.$- e x 12.00-FEE:S /Z� Check No.: _�j 0� / Receipt No.:� hve e I of 4 TYPE OF SEWERAGE DISPOSAL Public Sewer i� Swimming Pools Tanning/Massage,-Body Art Tobacco Sales Food Packaging Sales Well _ _ - Permanent Dumpster on Site _ Private(septic tank,etc. _ Electric Meter location to project NOTE: Persons contracting with unregistered contractors do not have access to the guaran(y.1 ind Signature of Agent/Owner Signature of contract Plans Submitted :❑ Plans Waived ] .Certified Plot_Plan ❑ Stamped Plans i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED , DATE APPROVED CONSERVATION ❑ COMMENTS DATE REJECTED DATE :APPROVED HEALTH ❑ i CONINIENTS Zoning Board ot'Appeals: Variance, Petition No: Luning Decision;receipt submitted y,.s Planning Board Decision: Comments Conservation Decision: Comments 1,Vatcr& Sewer connection,Signature& Date Driveway Permit Temp Dumpster on site yes_no4- Fire Department signature;date Building Setback (ft.) Front Yard Side Yard Rear Yard Required Prox ided Required Provides Required Provided I/ 4— j Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area,sq. ft.: N(7('GS and DA FA—(For department use) iI'•rc;nl l rLCI" ;^•.11.'-!:.I<`.RA S llLPAR I V:LN I`IWI i Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits u Building Permit Application Workers Comp Affidavit u Photo Copy Of H.I.C. And/Or C.S.L. Licenses u Copy of Contract u Floor Plan Or Proposed Interior Work Addition Or Decks L3 Building Permit Application j Surveyed Plot Plan o Workers Comp Affidavit u Photo Copy of H.I.C. And C.S.L. Licenses u Copy Of Contract u Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) L3 Building Permit Application u Certified Proposed Plot Plan o Photo of H.I.C. And C.S.L. Licenses • Workers Comp Affidavit • Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) zj Copy of Contract j tiiass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of:Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:1\.SPEC ION,V..SEM 1('LS DE11.1RTNIE.N'rd3PPOI1Nu15 rv, Lot 1 Location // 0�, IX:5,,ct S� No. Date M�RTM TOWN OF NORTH ANDOVER MITi • + ; , Certificate of Occupancy $ J'••°•Eta' Building/Frame Permit Fee $ ` wcNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # /r 19621 Building Inspector NORTH Town of .� t: 4Andover No. 203 ...� dover, Mass., =2 d 4 6 T o - LA E COCHICHEWICK RA T E D Pp '�5 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT..... ?4.Ap0j; ...........Wr o.. .H.�!.. BUILDING INSPECTOR Foundation has permission to erect........................................ buildings an#....4*Ana I......... ....♦..................... Rough to be occupied asad.....)Rw or......�� .�.................. .. Chimney provided that the rson accepting this permit shall in every respect conform to the terms of the application on file in Final 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 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRU. S NTS Rough .... ......... ..........�.... ........ ..... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. KEEN CONSTRUCTION CO. 21 HEWITT AVE. N.ANDOVER, MA 01845 (978) 691-5201 Turner, Pat &Leo 11 Oxford Ave. N. Andover, MA 01845 (978) 682-7194 -Contract;# 1642;.Appendix A Date :9/24/06 Remodel 2,d floor bath: • Demolish 2nd floor bath to studs • Insulate exterior walls and ceiling to code (R-13 in walls,R-30 in ceiling) • Supply& install blueboard on walls and ceiling and skimcoat plaster(walls to smooth finish; ceiling 40 to*4,.-„a r4p rs ) • Install customer supplied vanity • Supply& install customer selected ceramic tile on floor( as selected from National Tile dated 8/14/06) • Supply& install 6 panel pine door in existing frame • Supply&install.trim on base, door and window to match existing . • Supply& install two 36" white grab bars Electrical: • Supply&install outlet and switching to code (if a new circuit is necessary, customer will be charged accordingly) • Supply& install Panasonic fan/light combination as selected from Peabody Supply • Install customer supplied light fixture over vanity Plumbing: • Supply&install customer selected tub&toilet from Peabody Supply • Install customer supplied vanity top, faucet and shower valve Price does not include cost of permits, vanity, vanity top, faucet, shower valve, vanity light or changes required by inspectors. 1 KEEN CONSTRUCTION CO. 21. HEWITT AVE. N. ANDOVER, MA 01845 (978) 691-5201 Total Price:$10,675.00 (ten thousand six hundred seventy five dollars) Payment schedule:$3000.00 due when contract is signed $3000.00 due when bath is demolished $3000.00 due when bath is plastered $1675.00 due when contracted work is complete i Customer Ke `eth IB Keen 21 Date Date 2 7777 KEEN CONSTRUCTION CO. 1642 n 21 HEWITT AVENUE PROPOSAL NORTH ANDOVER. MA 01845 Tel: (978)691-5201 All home improvement contractors and subcontractors Fax: (978)682-3231 engaged in home improvement contracting, unless specifically exempt from registration by Provisions of Submitted "�'� �^- Chapter 142A of the general laws,must be registered with To: _..... ....e`. .._���........................ .-.__ ` me 4 the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, Home Improvement Contract Registration,One Ashburton .................. __-..._...___._... _ _._ -...._...._..___..__.-_._. ._-..--....-.......................... Place, Room 1301, Boston, MA 02108 (617) 727-8598. �.� �� Owners who secure their own construction related ............_._...___ _..........___.....,.-..... 4._ C' — permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c. 142A. P NE DATE REGISTRATION NO. F.I.D.NO. MA. H.I.C. 108383 04-325-8052 f j > C/S = Customer Supplied S + I = Supply + Install II We hereby submit specifications and estimates for work to be performed and materials to be used: (©of ...... ------------_ --._--_.-.__. .._... ...................5 '-e- _ n��-- -- - ----_ onstruction related permits: ....................... .................................................................................................................................................................... ............................. WORK....SCHEDULE.............. ................ .......................................... ................................ ............ ........ .... ......... ....... .................... ......................... ........................ ..... ............. .................... ...................... ...................................................................................................... Contract wil 1 begin the work or order the materials before the third day following the signing of this Agreement,unless specified here. ontr c or will begin the work on or about (date). Barring delay caused by circumstances beyond Contractor's control,the work will be com leted b f`� wner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered aslations of thate). The Ois Agreement. WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of G 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 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 c, nd "I el'�- eve. _/� Payment to be made as follows: dollars($ 7 / D 0 ) % ($ ) upon signing Contract; KENNETH B. KEEN Name of Contractor/Designated Registrant % ($ ) upon completAn-of 21 HEWITT AVE. r t Street Address % ($ letion of N. ANDOVER, MA 01845 City/State St all a made forthwith upon (978.) 691-5201 (978) 682-3231 \/ ) completion of work under this c4tract. Phone . , { e Fax Notice: No agreement for home irrtprovemenf contracting work `;KAI"requirit�a - >down payment(advance deposit) of more than one-third of the total contract price Name of Salesman 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 Authorized Signature equipment,whichever amount is greater. Note: This proposal may be withdrawn by us it 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 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. NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signatu21��, / i i, .. .. ?l�G G Date Signature Date IMPORTANT INFORMATION ON BACK 0- ✓die �aavrr�o�rr�uea�i o�✓�,a4��iav,L76 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 108383 Expiration: 8/18/2008 TYPe.;.:DBA KEEN,CONSTRUCT10N CO. Kenneth Keen 21 Hewitt Ave G1 u•ti No.Andover,MA 01845 Deputy Administrator j o� BOARD O✓ F BUILDING "icens e: REGULATrI ONS CONSTRUCTION SUPERVISOR Number:'CS 058245 r' f 3irthdate:::03%24/1943 I ;3 `EzpireS0312412008 Tr.no: 13436 ,z t 4 tRestricted,O9 ; KENNETHB KEEL 4' 21zHEWITTAVE "\ N AN00VER, I�AA,.0184.5tt . - j ` .. Commissioner The Commonwealth of Massachusetts JW Depm7ment oflnditstl•ial Accidents Office ofinuestigations 600 Washington Street, 7tf Floor Boston Mass. 02111 Workers' Compensation Insurance Affidavit Building/Plumbing/Elects ical Contractors A�Jplicant In'f/o'rmation= Blease-FR�T leQsbly address: city vNc)RZd ziaV/2 [1S phone#p-,72'G() J z,.( work site location(full address): ❑ 1 am a homeowner performing all work myself. Project Type: ❑New Constniction❑Remodel �1 am a sole proprietor and have no one working in any capacity. ❑Building Addition ❑ I am an employer providing workers' compensation for my employees working on this fob. company name: address: City: phone#- insurance co tt �s 33Policy# ❑ 1 am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractorslistedbelow who have the following workers'compensation polices: company name: address: city: phone#• insurance co o is 77 company name., address: City: phone#• insurance co. nnliry# Attach addigonal sheet if necessary w a Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or` one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I tlo hereby certi i the pains a d , es ofperjuiy that the information provitled above is trite and correct. Signature l Date ! 7 _ 70,6 Print name / Phone# _;s '4:: �:;':.1a°,s..;5;i',x�.ti:?i•'''.r,.x'4. :, ,v,,..t3..,.,D .r.:}v s ... .. ` t•.��,,., ' :x,,.as rte. .:'_`� z"£sa'%, 8..a:.;' ;.;x•,,. : ... .. r ,. ., .. „ official use only do not write in this area to be completed by city or town official city or town: permit/license# "^ P ❑Building Department !S ❑Licensing Board ': E)check if immediate response is required ❑Selectmen's Office rej contact person: phone#; ❑Health Department ❑Other (revised Scpi.2003) q •. .,:..:.,;' 3 ..,..:... ,.'.:'.'..�'.s:'ilt�C.1'„�'...e?C�f,�"�'1fi x .. �L . .�,r. S i