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HomeMy WebLinkAboutBuilding Permit #277-15 - 25 CRANBERRY LANE 9/16/2014 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0:02-"AO` Date Received Date Issued: V1 I(Q I l IMPORTANT:Applicant must complete all items on this page LOCATION Z5 C f c,r\ berry L✓1 Pr nt PROPERTY OWNER �c•J � �b � �°c.-�-�i r- lC.e,51 C, Print 100 Year Old Structure yesno MAP NO: PARCEL: 9 ZONING DISTRICT: Historic District yes o Machine.Shop Village yes o TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial IO Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer n DESCRIPTION O WORK TO BE PERFORMED: GNl a S (— Identifica ion ease Type or Print Clearly) OWNER: Name: *{)Ci f -f Lient r =- kes(C'n Phone: 973' g9 LI _5 /Zd Address: 2 5 Cirr,n be LY) l , An dG\jv r' CONTRACTOR Name: WePn 60 rQC -G% l . Phone: 991 " 522d/ Address: 105J rn Ve /R Q/IF Su,pervisor's Construction License: CS 6.7(6 91 Exp. Date: z 6 Home Improvement License: 1 C �J?S Exp. Dater p p ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT. $12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BRAS"ED ON$125.00 PER S.F. Total Project Cost: $ Z9) 342— 0 0 U FEE: $ Check No.: 02 j--3Receipt No.: �� NOTE: Persons contracts g with unregistered contractors do not have access,to t u an and Slgnatureof Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ Location 'Z V5 J u aI}P a P `^ _ No. '^ ' t Date `<o . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ � Building/Frame Permit Fee $3`�� •� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# Building Inspector Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ 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 HEALTH Reviewed on Signature COMMENTS S Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/ Driveway Permit DPW'Town Engineer: Signature: Located 384 Osgood Street FIREbEPARTMENT - Temp Dumpster on site yes no Located at'U4 MainStreet Fire Departinentsignatdre/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 U Notified for pickup - Date Doc.Building Permit Revised 2010 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 Paan ❑ 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 4 must be subm..ted with the building application Doc: Doc.Building permit Revised 2012 Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 29,342.00 m $ - $ 352.10 Plumbing Fee $ 44.01 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 44.01 Total fees collected $ 540.13 25 Cranberry Lane 277-15 on 9/16/14 Master Bath Remodel r , NORT1-r - : w ic . : ve: � No. - C, h ver, Mass0 L#' a coc.uc"I 'C" �1 �f.9s 4ATED 11 BOARD OF HEALTH Food/Kitchen PERMIT T LD 1Septic System THIS CERTIFIES THAT ........ .. ..C�; �E� ( `� GI. ............................................................. BUILDING INSPECTOR Foundation has permission to erect .......... .............. buildings on ....... .... ... ...04. ............................... Rough to be as occupied p� ................. G/!yi d oLG./...... �...:..��...�.�. ..�.�.��................................................. 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 CONSTRUCTION STARTS Rough /� Service ............ ... r1. ll ✓.::��':................................... Final BUILDING INSPECTOR 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. 5, 5'i 1 KEEN CONSTRUCTION CO. 1175 TURNPIKE STREET 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 Submitted I N � _ I! `�Q with the Commonwealth of Massachusetts. Inquiries To: �GU f� (!ly �'k, J about registration and status should.be made to the Director,Home Improvement Contract Registration,10 rrn� 7e r�✓ Park Plaza, Room 5170, Boston, MA 02116 617-973- 8787 Owners who secure their own construction C related permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c.142A. PONE DATE REGISTRATION NO. EIN NO. 771 S_ 9 10 .9 )_7 /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: RPIct /w > Construction related permits: _._.._ _.�_......... .._._....-.._._._......,_. — ....._.................................................................................................................._:.._.._......... _.................. ..... ..._.....__—____---------- -__ ...... .._._..._. WORK SC *EDContract eworkor order the materials before the third day following the signing of this Agreement,unless specified her jr+ 1 g. tractor will begin the work on or (date). Barring delay caused by circumstances beyond Contractor's control,the work will be completed by U�(date). The Owner hereby edges hat the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not a cons dered 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 r r agents,s or completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials,or damage caused by the Contracto,his subcontractors,employee 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 e o remedied, is 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-compI t in ac ordance with above specifications,for the sum of q A i c,-2 v Sunk 0� U/0 dollars($ Payment to be m de as follows: )• % ($ ) upon si ning Contract; ROBERT A. KEEN Name of Contractor/Designated Registrant ($ ) upon�o I6ti0yof 1175 TURNPIKE ST. rsall'be Street Address Completion of N. ANDOVER, MA 01845 97 stale 'made forthwith upon -(978)691-5201 (978)682-3231 completion of work under this contract. Fax Notice: No agreement for home improvement contracting work shall require a -0e'✓1 >down payment(advance deposit)of more than one-third of the total contract price Name of, a an 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 Ault .ad i a ure 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 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. DO NOT,SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature Dale IMPORTANT INFORMATION ON BACK ► - 7 een r; Consfucfion Co; REMC�t�E1_IM4 SPEGt/�IISTS 978-45P —520'1 Keen Const ructionCo.corn Payment Schedule:$5000.00 due upon signing contract $5000.00 due when plumbing fixtures are delivered (except back-ordered items and shower doors) $4000.00 due the first day of work(plus permit fees) $4000.00 due when rough electrical and plumbing are complete $3000.00 due when plaster is complete $4000.00 due when tile is complete $4342.00 due at completion of contracted work Customer Robert A. Keen Date Date 1175 Turnpike St. P: 978-691-5201 N. Andover, MA 01845 F: 978-682-3231 CSL#076691 Sales@KeenConstructionCo.com HIC #108383 REMC�DELIAC: SPECGI/aLISTS 97;r8-69-1—S207 KeenCons tructionCo.com Takesian, Paul & Heather 25 Cranberry Ln. N.Andover, MA 01845 Contract#5511;Appendix A September 16,2014 Remodel Master Bath: • Demo existing master bath to studs,ceiling joists and sub-floor • Dispose of all debris • Frame linen closet where existing shower is located • Update electrical as needed to code • Relocate plumbing pipes as needed to move shower to current tub location (installing new drain to basement will be extra) • Supply& install insulation to code • Supply& install blueboard and skimcoat plaster to smooth finish • Install customer supplied cabinetry and related trim • Supply& install plumbing fixtures as selected by customer from Peabody Supply on quote #390978 • Supply& install the on floor,shower walls and shower floor as selected by customer from National Tile on 9/4/2014 • Supply& install new trim to match existing • Paint walls, ceiling and trim (two coat finish,two neutral colors) Total Price: $29,342.00(twenty nine thousand three hundred forty two dollars) Price does not include cost of permits, cabinetry, counters, installing new drain (if needed), or repairs to any unsafe, unusual or non-code compliant existing conditions. 1175 Turnpike St. P: 978-691-5201 N. Andover, MA 01845 F: 978-682-3231 CSL#076691 Sales@KeenConstructionCo.com HIC#108383 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): ��(��;,� (G A CW—) . Address: 1175 TU i'fl ps k-o, City/State/Zip: (1Jr Phone #: Are you an employer? Check the appropriate box: 1.[�] I atn a employer with Z 4. ❑ I am a general contractor and I Type of project(required): 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' [No workers' comp. insurance comp. insurance. $ 9. Building addition 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 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: 7f`rwt I e r 5 ,n 5'ul ro,1,) 6-e _ Policy# or Self-ins. Lic.#: �: N�,� — / I' ► :.J 2 — Expiration Date: Job Site Address:-),.5r,(-e,,bu,,, Lo 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 ascivil 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 cert�if/y er tl a pait, nd penalties of perjury that the information provided aboveis rue and correct. Signature: T / " Date: 91 Iq Phone#: ? D ' (i� � 5'2,0 f 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#: Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-058245 KENNETH B IKEE.14 ; 21 HEWITT AW- N N ANDOVER MR 01 4, / Expiration Commissioner 03/24/2016 !: "N. Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-076691 ROBERT A KEEN 12 E WATER ST North Andover Nf1 01 ,v Expiration Commissioner 08/16/2015 { p� �� F \ Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR egistration: 4,68,383 Type: xpiration:c;=81-f1-203:6;, DBA KEEN CONSTRUCl'1;0 5, Kenneth Keen pis 1175 TURNPIKE ST {'? NO.ANDOVER, MA 01845'' Undersecretary Aco4/15/20144 ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/Y Ill 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 CONTACT Barbara McDonough NAME: g Gilbert Insurance Agency, Inc. PHONE (No, 761)942-2225 A/� o. (781)942-2226 137 Main Street E-MAI ADLDRESS• gg m bmcdonou h@ ilbertinsurance.co INSURERS AFFORDING COVERAGE NAIC 8 Reading MA 01867-3922 INSURERA:NORFOLK & DEDHAM INSURANCE 23965 INSURED INSURER B:Hartford Fire Insurance Com an Keen Construction Company INSURERC:Travelers Insurance 0022 1175 Turnpike Street INSURER D: INSURER E: North Andover MA 01845 1 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1441500922 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 CONDLTION_OF.-ANY._t^ONTRACT OR OTHER DOCUMENT WITH RESPECT-T_O-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 ADDL SUER POLICY NUMBER MM/DDYYY MLICY EFF M LICY EXP LTR /Y /DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DPREMISES AMAGE TOEa RENoccurrenceTED $ 100,000 A CLAIMS-MADE a OCCUR D-P-010078/000 /13/2014 /13/2015 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY (CE SINGLE LIMIT EaaMccident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 08UECAA6432 12/3/2013 12/3/2014 AUTOS Ix AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS AUTOS Per accident $ Underinsured motorist $ 100,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ C WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) 6HUB-9991M58-2-13 10/8/2013 10/8/2014 E.L.DISEASE-EA EMPLOYE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE M Gilbert, CIC/BARBAR ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD