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Home My WebLink AboutBuilding Permit #263 - 28 MOODY STREET 10/5/2006 TOWN OF NORTH ANDOVER NO R TFC APPLICATION FOR PLAN EXAMINATION °`tt�•° b,q'�'o ~ A Permit NO: � Date Received /0 •5 'D� +� i ^ � �as g1TED X41) Date Issued: V - 7 ' 1 SAc"US� IMPORTANT:/Applicant must complete all items on this page LOCATION 7.75 XnoC& / Prin PROPERTY OWNER Art 2a C Print MAP NO.: � t PARCEL: 1 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ne family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: air, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑ Moving(relocation) ❑ Other ❑ Others: ❑ Foundation only DESCRIPTION OF WORK TO BE PREFORMED / Itc-ain.c j7 i-u ii,an /C-43nA -L& 0 ,o Fx�ti71:n/C, 'Teck Identification Please Type or Print'Clearly) OWNER: Name:&2 L;Aj E-e0nb Phone:9'TP` 697-61Z35- Address: Z Pntc-o d c/ sl CONTRACTOR Name: X2I.If-i LDIyS�ILc�L-��./ Phone:9vT6`697-9�1 Address: Z I ��'� GcJ /l/�E t-'• Supervisor's Construction License: 5_2 -2-Y3— Exp. Date: —J' ' Z - ,o Home Improvement License: !O Exp. Date: Q 'D ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$115.00 PER S.F. Total Project Cost :$ 1'30 l• 0 S FEE:$ l60 Check No.: .3291 Receipt No.: �! Page I of 4 TYPE OF SEWERAGE DISPOSAL Swimming Pools ❑ ❑ Public Sewer Tanning/Massage/Body Art Well F1Tobacco Sales ❑ Food Packaging/Sales [I❑ 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 guaranty fu Signature of Agent/Owner Signature of contractor• Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS • ' DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site 'yes Fire Department signature/date COMMENTS Zoning Board of Appeals: Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: - Comments Water& Sewer connection/Signature& Date Drivewav Permit Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) II Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Created 1MC.Jan2006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 Location�C1 171 ood s - s�- No. c�9z2 Date LU V NORT1y TOWN OF NORTH ANDOVER Certificate of Occupancy $ ��s'•° E�� Building/Frame Permit Fee $ b JACHUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # k 19654 Building Inspector tA T#j Tovm of Andover No. LG 3 0 ,- 0% 00 dover, Massje C C:MIC HEWICK BRAT E D Is, BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT..................681 1W 4-4.0 BUILDING INSPECTOR ................ .4 . ......................................................................... Foundation Rough has permission to erect...................................... buildings ongpi..... .............................. F rut% ... .. .. ....... 0 Rough to be Occupied ax.Wj....Wol.d.was .. ......4N IN& b14 rmjhimney t .. t,..j provided that the person accepting this per ks2iii�n every respect conform o t e terms of the application on�fi eein 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 11000000 PERMIT EXPIRES IN 6 MONTHS Final A Service UNLESS CONSTRU T.� No TS ELECTRICAL INSPECTOR .................... BWUPULMIDWIWNMINS�OR Rough ............ . ............ Final Occupancy Permit Required to Ocaipy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner r Street No. SEE REVERSE SIDE Smoke Det. Board of Building Regulations and Standards = HOME IMPROVEMENT CONTRACTOR Registration: 108383 Expi ration::':8118/2008 .Type:D:BA KEEN_CONSTRUCTION CO`. Kenneth Keen 21 Hewitt Ave No.Andover, MA 01845 Deputy Administrator j i lie,&aar�noruu o�� czc�ivae�t C r BOARD OF BUILDING REGULATIONS icense: CONSTRUCTION SUPERVISOR Number:'CS 058245 3irthdate 03/24/1;943 zpires 1)3[24/2008 Tr.no: 13436 k itestrictedj 00 , +, KENNETHB KEEN 21'H Evv I N ANDD_VEIL, MA_b1845 -� { '- Commissioner ' i WK- The Commonwealth of Massachusetts __ Depal•tment oflndustl•ial Accidents c - :_,� Office of fnuestigations �� - 600 Washington Sheet, 7r''Floor �- � Boston,Mass. 02111 Workers' Compensation Insurance Affidavit Building/Plumbing/Electrical Contractors Aliplicant infoi=matfon Please PRl1�T legibly name: K I►� 1-�1�"f JS�. address: L 14 /eL�l.w I ! tfG^ city NI�IZ-� tj( L��2/L state': //! zip 0462yls phone#9Z9-sb:7J Z.O work site location(full address): ❑ 1 am a homeowner performing all work myself. Project Type: ❑New Constniction❑Remodel K] am a sole proprietor and have no one working in any capacity, El Building Addition ❑ I am an employer providing workers compensation for my employees working on this fob. company name: address: city: phone#• insurance co Volicy# r•' j:x..°a v;�+?S�',w'; .:Ali. h�:..:. r�',..r ( ., a Yf :i "'Mi ! .:Z,�' `,Ei +.f t Jt i:::.5r - .:f¢3 TAt ❑ 1 am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers'compensation polices: company name: address: city: phone#• insurance co .,. Vol # company name•' address: city: phone#• insurance co ohc # Attach addihmiahslieet if necessary - r 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. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby cerci the pains a d f es ofpeijitty that lite information provirled above is true and correct. Signature Date 10 — 5 -06 Print name At OLU Phone# 4 i :_/), 0"I't official use only do not write in this area to be completed by city or town official •t city or town: permit/license# ❑Building Department N., Fc^ V-5 ❑Licensing Board ❑check if immediate response is required ❑Selectmen's office + contact person: [:)Health Department hone";� (revised Sept.2001) p ' ❑Other y - _...::.: ,a F 5..:_:: t..it y.�ur:,"�:k_a*S:rvr^.��Fi.`< -...�C ;,. 1�:e :I{i ._.t,. �..r � r n„h�'k S+• i 4.., % 1. v.r. ... 1649 KEEN CONSTRUCTION CO. PROPOSAL 21 HEWITT AVENUE NORTH ANDOVER. MA 01845 Tel: (978) 691-5201 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 with Submitted _ s "i �" 7— ( _ the Commonwealth of Massachusetts. Inquiries about To: ri �..L_, ,�� j-c.. - - --- c'� registration and status should be made to the Director, Home Improvement Contract Registration,One Ashburton Place, Room 1301, Boston, MA 02108 (617) 727-8598. J Owners who secure their own construction related j r ,__C 1 ..v permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c. 142A. PHONE DATE REGISTRATION NO. F.I.D.N0. MA. H.I.C. 10838304-325-8052 > C/S = Customer Supplied S + I = Supply + Install We hereby submit specifications and estimates for work to be performed and materials to be used: /G (r' t/ i�" ' '�. &Aj /.U 1 C G.1 L C 1/ _- ...... _. - �l .......... — -- -. -------......-- ...._._.. C, . r _ .�.� r _ , ... ,1l:.l..L Construction related permits: ...... -....... ......./.....................................................-..... ........................................................................_................ ...................................... ............................(.......�C ,1.c....... .. ...a..�........Ir_.%._�_t "i.._ _. ... WORK SCHEDULE , 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 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 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 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 � � / / i +� I� r1N - �__ jlZ ✓INC� tf; � Y �i�F dollars($ Payment°to be made as follows: / )• /° G 6 -3 KENNETH B. KEEN ($ ' j upon signing Contract;{' t . 7 q D Name of Contractor/Designated Registrant ($ a �) upon completion of21 HEWITT AVE. Street Address ($23of —) upon completion off}/��; `� f r.� N. ANDOVER, MA 01845 �7 �( :.0 City/State % ($ ) shall be made forthwith upon (978) 691-5201 (978) 682-3231 completion of work under this contract. Phone Fax Notice: No agreement for home improvement contracting work shall require a >down payment(advance deposit)of more than one-third of the total contract price Name o!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 Aulhoez� 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 - r r Date - /' _ Signature Date IMPORTANT INFORMATION ON BACK ►