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HomeMy WebLinkAboutBuilding Permit #395-12 - 129 OSGOOD STREET 10/11/2011 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: J Z Date Received ' Date Issued: IMPORTANT:Applicant must com lete all items on this page LOCATION ! 1 © S E o �T Print PROPERTY OWNER A rA N W o 0 C� Print MAP NO:(0 PARCEL: ! F ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition 4?Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial O4eeair_replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Efl'$Op 0 Well ❑Floodplain q Wetlands UVatersliedD strict - R DESCRIPTION OF WO TO BE PERFORMED: ASA ):I-fL fpqNQ ! yu,, GAIZ Identification Please Type or Print Clearly) OWNER: Name: {tea ry� 2�� 6d��. Pone 7a Q taz Address: 13 t Sg64vc} S�� CONTRACTOR Name: 0() PJSt Phone: (z(� Address: 9 ( i'£ LV I � �V tt-� I&J. o Supervisor's Construction License: S g V y s Exp. Date: 1- Home Improvement License: / t) S3 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ A% 57 .3 -0c) FEE: cb Check No.: 4.994 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of�Agent/Ovvner Signature of contrac#_ e"— . i ed Plans Stam❑ ❑ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan p i TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS -LJ 5S I r 1 HEALTH Reviewed on Signature 007 'P COMMENTS 4�/ d Zoning 6'dard of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature 8< Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$10041000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 r 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 ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ 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) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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: Doc.Building Permit Revised 2008mi Location .� S17 ozz sl`!� No. Date °RTM TOWN OF NORTH ANDOVER f �,r 00 O P i Certificate of Occupancy $ CHUS � Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ? 247 50 `I- ilding Inspector AORTH TO" Of 0 ., Akrx INTO. .;V. _n LAKE over, Mass., I� coC MIC ME WICK �� 7�ADRATED F`PC .S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......... k,;./W... ........................................... ............................................ Foundation has permission to erect........................................ buildings on ./j// 0: C .. ... ...... ........................... Rough to be occupied as................... ,r1c.l , c. �sem. ,,( .1;..Pi.s'.(a.. .14........................................................... Chimney . ..... .. provided that the person accepting this permit shall in every r pest confor o 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO TARTS 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 FIR_E-DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. NOTE: mz,00 HEADER AT WINDOWS, TYP, PRE-EN61NEERED ATTIC ROOF TRUSSES 5/8" SHEATHING z 8 12 0 ROOFING MATERIAL TO BE SUPPLIED BY OWNER EXISTING CMU WALLS IL EXISTING CMU WALLS TO REMAIN TO REMAIN REMOVE EXISTING SLAB AND REPLACE WITH NEW 4" CONCRETE SLAB 2X6 STUD WALL REMOVE EVERY OTHER BLOCK AND REPLACE WITH NEW 8"Xlh" BLOCK - EXISTING CMU WALL TOOTHED IN AT CORNERS NEW 8" CONC. FOUNDATION WALL IOC ON NEW W'XS" CONCRETE FOOTING 4" CONC, SLAB ON 6" CRUSHED STONE W/ — - - - - - - - - - - 7 - - - - - - - - - - - - - - - — POLY VAPOR BARRIER u - - - - - - - u - - - - - - - - - 1111 31-/11 1111 C3, oil 7I -� 8" CONC. FOUNDATION KJ 4' 8"X16" CONC, FOOTING (2)2XI2 CONTINUOUS HEADER - 27' LOWS I 27' —1L TYPICAL WALL SECTION \-M-51ION L CFxOARAGE 1/4111=1'-O DOOR FRAMING REQUIREMENTS FLOOR PLAN 1/411=1'-o DFRAWN E3Y; SEPT. 2, 2011 MARTHA MACINNIS PROPOSED GAFRAGE RENOVATION 58 REGENT AVE, BRADFORD, MA. 01835 131 OSC400D ST REE (g78)374-8719 NORTH ANDOVER, MA, 8 F 12 NEW ROOF-f NEW FRAMED GABLE END UTALL-� CLAPBD, SIDING REMOVE EVERY OTHER MOCK AND (3)2XIO HEADER AT REPLACE WITH NEW 8"XIro" BLOCK - WINDOWS, TYP, TOOTHED IN AT CORNERS f- NEW FRAMED WALL (- - - - - EXIS71 !G WINDOW "ISTINPBLOCK WALL FRONT ELEVATION SIDS ELEVATION � - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - DRAUJN BY: SEPT. 2, 2011 MARTHA MACINNIS PROPOSED GARAGE RENOVATION 58 REGENT AVE, BRADFORD, MA, 01835 131 OSGOOD STREET C978�374-8719 NORTH ANDOVEI;R,, MA. 2 KEEN CONS7'2uC7"ION CO. 21 HEW17"T"AVE. N. ANDOVER, MA 01845 978-691 -5201 KeenCav►s&act't avt.Ca:caves Greenwood, Pam 131 Osgood St. N.Andover, MA 01845 978-725-0122 Contract#5068;Appendix A Date: October 9, 2011 Remodel existing garage: • Remove and dispose of existing doors,wood framing and roof • Excavate and pour frost wall and new floor as per drawings dated 9/2/2011 • Saw-tooth existing block walls as per drawings • Framestudwall and roof as per drawings • Supply&install PVC trim and cedar clapboards • Supply& install 9-lite Thermatru Smooth Star door and 29'x 7'6" insulated steel garage doors with operators Total Price:$29,873.00(twenty nine thousand eight hundred seventy three dollars) Price does not include the cost of permits,finished roofing, painting,electrical work or problems found while digging. Payment schedule:$1,000.00 due upon signing contract $6,000.00 due the first day of work $6,000.00 due when demo is complete $6,000.00 due when block wall is complete $6,000.00 due when framing is complete $4,873.00 due at completion of contracted work Customer Robert A. Keen j�I� �aolJ &9 .Z11 Date Date Massachusetts - Department of Public Safety Board of Building- Re�-ulations and Standards Construction Supervisor License License: CS 76691 r� f ROBERT A KEEN 12 E WATER ST N ANDOVER, MA 01845 ° Expiration: 8/16/2013 ( nunisiuncr Tr#: 3772 Massachusetts- Department of Public Safe'tN Board of Building Re<„ulations and Standards Construction Supervisor License License: CS 58245 Restricted to: 00 KENNETH B KEEN 21 HEWITT AVE N ANDOVER, MA 01845 Expiration: 3/24/2012 ( uuuuis.nm'r I r#. 20523 ��QQ --. ,,.,,�� OtficeAt"Lomer airsiness egu a ona HOME IMPROVEMENT CONTRACTOR r Registration: ,108383 Type:. f Expiration: Va8%'012 DBA k K CONSTRUC1IOt�fi Kenneth Keen j 21 Hewitt Ave No.Andover,MA 01845 Undersecretary 8/22/2011 1:36 PM FROM: Gilbert Gilbert Insurance Agency, Inc. TO: +1 (978) 682-3231 PAGE: 001 OF 002 ACORDN CERTIFICATE OF LIABILITY INSURANCE PDATE/z/2011 PRODUCER (781)942-2225 FAX (781)942-2226 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION Gilbert Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 137 Main Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Reading, MA 01867-3922 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW: INSURERS AFFORDING COVERAGE NAIC# INSURED Kenneth Keen & Robert Keen INSURERA NORFOLK & DEDHAM INSURANCE 23965 DBA: DBA Keen Construction Company INSURER B: Granite State Ins. Co. 0077 21 Hewitt Ave. INSURER C: North Andover, MA 01845 INSURER o: INSURER E: OVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRNSR ADD TYPE OF INSURANCE POLICYNUMBER POLICYEF�D E POLICYEXDATE PI TION LIMITS GENERALLIABILITY ND—P-010078/000 03/13/2011 03 13 EACH OCCURRENCE / / /2012 $ 1,000,00( X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,00( CLAIMS MADE �OCCUR MED EXP(Any one person) $ 100,60( A PERSONAL 8 ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per.accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLALIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND W0009646942 08/03/2011, 08/03/2012WCSTATII OTH- EMPLOYERVLIABILITY - 4Y0 CERT TO BE MAILED B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBERE)(CUIDED7 DI ECTLY VIA INS CARRIER E.L.DISEASE-EAEMPLOYE $ 100,00 It yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - Evidence of Coverage ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Evidence of Coverage ALITHORIZEDREPRESENTATNE Mark Gilbert CIC ACORD 25(2001108) OACORD CORPORATION 1988 i KEEN CONSTRUCTION CO. GP a 21 HEWITT AVENUE PROPOSAL 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 with ? Submitted , the Commonwealth of Massachusetts. Inquiries about . ................._ - registration and status should be made to the Director, �( r1' Home Improvement Contract Registration,One Ashburton .. �-� ��C I ........ Place, Room 1301, Boston, MA 02108 (617) 727-8598. j _ s 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 DATE REGISTRATION N0. F EIN NO. MA. H.I.C. 108383 ' ,� J 1 < /C,'A-���1 26-0462904 > 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: _............... ... r i J. .ir ._ V f � .� ✓ i .........._......_......_.._.__._..__. _............. i ................._...-_-----------.__.__.. 1 __...__...._.._____._.. i .... _.._ I 1 _ _._.........._--.....__........... _______-.__ _______.-______________ > Construction related*permits: _ __._ _....__ _._.......,_..._...,..__..............._...._..._.._......_..,..._.............,.........................................,..,........................................................................._......................................................................,,.......................... .......................... � _ __.._..._.._,.__........_._...,....._...__......._...................................................................._.................................................................. ...................................................................-...................................................................................................................._.................. WORK SCHEDULE .................... J�J Contractor will not begin the work or order the materials before the third day following the signing of this Agreement,unless specified here in writing. Contractor will begin the work on or I about (date). Barring delay caused by circumstances beyond Contractor's control,the work will be completed by (date). The Owner 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 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 , �C!� following completion and shall I comply with the requirements of this Agreement. In the event any defect in workmanship or materials,or damage caused by the Contractor,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. ! i We Propose hereby to furnish material and labor-complete in accordance with above specifications, for the sum of: ^1 11 y (V. j �c-t�lvc n r� t i uv)dye .J � �1 y Yt � 2 dollars($ '�. 3� ` 0C ) Payment to be rniide as follows: i % ($ } upon signing Contract; �/tt KENNETH B. KEEN / ROBERT A. KEEN 1 Name of Contractor/Designated Registrant ! % ($ ) on { 1I ,tio Of 21 HEWITT AVE. ' 1�,!� Street Address °/ ($ pon completion of N. ANDOVER, MA 01845 City/State �)% ($ ) shall be made forthwith upon (978) 691-5201 (978) 682-3231 completion of work under this contract: Ph o Fax e Notice: No agreement for home improvement contracting work shall require a �t tig � >down payment(advance deposit)of more than one-third of the total contract price Name n��7al manor the total amount of all de osits or a ments which the contractor must make, inP P Y - j advance, to order and/or otherwise obtain delivery of special order materials and Authorized Signature equipment,whichever amount is greater. j Note: This proposal may be withdrawn by us it not accepted within days. I i 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. i 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 BLANK SPACES. Signature DatJA§ a Signature Date IMPORTANT INFORMATION ON BACK ► I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): E N ov N S�t2 0 ci i OCD Address: JH e ld _( U e �lgS City/State/Zip: A , /, p o t,� /Y11} Ph`�one#: 1� A- 6 q i / Are you an employer?Check the appropriate box: Type of project(required): 1.9 l am a employer with—� 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. $ 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers' comp, c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.] t employees. [No workers' 13.[1 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f 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 their workers'comp.policy information. Iam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: G t2f-) y♦ +-c Policy#or Self-ins.Lic.#: uQ C 04)of L (4 6 9 qa• Expiration Date: g —3 Job Site Address: /3 �Q'�Dc S 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. I do hereby cern der the pain and enalties of perjury that the information provided above is true and correct Signature: 01 -c Date: Phone#: �_7 0 •l.9 ( ',� a-O t 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#: