Loading...
HomeMy WebLinkAboutBuilding Permit #708-15 - 49 KARA DRIVE 3/11/2015Permit No#: Date Issued: LOCATION Odtt� yyv4 LT - BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION MI5 Date Received 3111115 IMPORTANT: Applicant must complete all items on this page r— ' Pri t PROPERTY OWNER DU4 � 1 "' SSC, 1 i Y�ta 4 Print 100 Year Structure yes MAP 0,95 PARCEL t ZONING DISTRICT:�Historc District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial [Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑ Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑ Water/Sewer D SCRIPTION O WORK TO BE PERFORM D: lit �� f C nem as -(mei dcvnett _P11- C/ OWNER: Name: U a J ; Contractor Name:1)6 Address: ification - Please Type or Print Clearly ✓/S Phone: 97 rn 01 t(p S Supervisor's Construction License: <-5 d 7 (PC 9I Exp. Date: Home Improvement License: 1 $ Exp. Date: ARCHITECT/ENGINEER Phone: - �7 5 z�&S I& // 9// IF // G Address: Reg. No. FEE SCHEDULE: BULDING PERMIT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. 44ft Total Project Cost: $ 3 0 FEE: $ Check No.: - Receipt No.:�24 ��� NOTE: Persons contracting with unregistered contractors do not have access to theZuanj4�y�und Signature of Ag_ _ __ ner Signature of contractor 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 PLANNING & DEVELOPMENT Reviewed On Signature COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS S Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes r' Planning Board Decision: Conservation Decisio Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT - Temp 'Dumpster on site yes_ Located at 124 Main Street Fire Department signatureldate COMMENTS Locatea Jd4 Usgood Street no `Y, 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 MGL Chapter 166 Section 21A —F and G min.$100-$1000 fine NU I t5 and DATA — (For department use ❑ Notified for pickup Call Emai Date Time Contact Name Doc.Building Pennit Revised 2014 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/Cross Section/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: Building Permit Revised 2014 Location 00 No. V ` Date' ' III,) Check # i—IS—Z TOWN OF NORTH ANDOVER Certificate of Occupancy $—.W_ Building/Frame Permit Fee $� Foundation Permit Fee $_. Other Permit Fee $ TOTAL $ k Building Inspector r 0 O O E L O a U) 0 a� m L O tm N m t 0 z 0 a J 0 FM V O G co Z U) ujw CL w H W IL O U U) J Z VI 0 ui CL Z CD 0 m V v O E O L v Z Q O N CD Co 'O 'r_ C- F— M O �+ V i c CL CL CL CF) Q 0s J .a .0, -J O ,a+ r Z 0 CL V N m C 0= 0l O O ca o CL a) a� Q - 0 wt y Q L N O +� � E 0U0: Z U W W er N 0 d 2 Z Z Wa o~c Z Q J (A Z CL Z Z u a m N LL co � yVj � N � N m J d J W ++ cu u Z N to m N y Y t C L t U N Y -O •y C C _ _ i O O ' O. 0 C fa j f6 > N 7 .@ C Q) O i C o C p N O 7 y E LL (n LL W U LL O' LL N LL d' LL m h N O E L O a U) 0 a� m L O tm N m t 0 z 0 a J 0 FM V O G co Z U) ujw CL w H W IL O U U) J Z VI 0 ui CL Z CD 0 m V v O E O L v Z Q O N CD Co 'O 'r_ C- F— M O �+ V i c CL CL CL CF) Q 0s J .a .0, -J O ,a+ r Z 0 CL V N m C 0= 0l O O ca o CL a) a� Q - 0 wt y Q L N +� � E O E L O a U) 0 a� m L O tm N m t 0 z 0 a J 0 FM V O G co Z U) ujw CL w H W IL O U U) J Z VI 0 ui CL Z CD 0 m V v O E O L v Z Q O N CD Co 'O 'r_ C- F— M O �+ V i c CL CL CL CF) Q 0s J .a .0, -J O ,a+ r Z 0 CL V N m C 0= 0l ConJtc�cf�an co, eemoUEl_I/VC; SPEGI/_�LISTS 978-697-520't KeenConstructionco.com i Alaimo, David & Missy 49 Kara Dr. N. Andover, MA 01845 978-975-2405 Contract #5517; Appendix A Basement Door: March 9, 2015 • Remove and dispose of existing 36" x 78" door between basement and garage • Supply & install similarly sized 20 minute fired -rated, 6 panel wood door unit, including aluminum threshold, new lockset and casing to match existing Attic Staircase: • Remove and dispose of existing house fan • Re -frame ceiling joists • Supply & install new wood pull-down staircase (MFS Excel with Thermogard insulation) • Patch ceiling as needed • Patch existing scuttle hole • Supply & install trim on staircase to match existing Bathroom Fans: • Remove and dispose of existing bath exhaust vents • Supply & install two Delta Breez 110 cfm bathroom exhaust fan/light combination units on existing switches • Supply & install two eave vent kits • Supply & install insulated 4" vent hose Total Price: $3680.00 (three thousand six hundred eighty dollars) Price does not include cost of permits, painting or repairs to any unusual, unsafe or non -code compliant existing conditions. 1175 Turnpike St. N. Andover, MA 01845 CSL #076691 Page 1 of 2 Sales@KeenConstructionCo.com P: 978-691-5201 F: 978-682-3231 HIC #108383 - � :Cans%ucfion. Cg, RFA C-3DFLINCi SPECILALISTS 978-691-520"1 KeenConstructionCo.com i Payment schedule:$1000 due upon signing contract $1300 due when attic stairs is installed (plus permit fees) $1380 due upon completion of contracted work Customer Robert A. Keen 3 he i6 Date . Date 1175 Turnpike St. Page 2 of 2 P: 978-691-5201 N. Andover, MA 01845 F: 978-682-3231 CSL #076691 Sales@KeenConstructionCo.com HIC #108383 5 5 KEEN CONSTRUCTION CO. PROPOSAL ° 1175 TURNPIKE STREET 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 pggq`I/r ti . Chapter 142A of the general laws, must be registered Submitted �Iw� Ir 1 I Sly `� M� with the Commonwealth of Massachusetts. Inquiries �l r about registration and status should be made to the Director, Home Improvement Contract Registration, 10 Park Plaza, Room 5170, Boston, MA 02116 617-973- 8 787 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 NO. EIN NO. 9� % 1J — Z J �5 , j�� bo (� 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: )-'P > Construction related permits: WORKSCH i "---""' . .'........................_......_...__._._........__..............._.....__.... ..... _._......__....._._._..............._..................._..............._....,.........._....................._.._.......,_....................,..:......................................__.............- ........_.._............_..... ..__........... ........... ....... ...._..........._..........._._. " Contra i no n the work or order the materials before the third day following the signing of this Agreement, unless specified her in ntln on actor will begin the work on or about , (date). Barring delay caused by circumstances beyond Contractors 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 no be con idered 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 v �2 -T�1Do's0 � cJi X `���(���E� a i,�h�� _-- —'dollars($ 3(c Payment to be made as follows: /e ($ ) upon signing Contract; ROBERT A. KEEN Name of Contractor / Designated Registrant ($ upon oniidC 1175 TURNPIKE ST. Street Address e� o completion of N. ANDOVER, MA 01845 City / Stale shall be made forthwith upon (978) 691-5201 (978) 682-3231 % ($ ) completion of work under this contract. Fax Pho Notice: No agreement for home improvement contracting work shall require a e , I` > down payment (advance deposit) of more than one-third of the total contract price Name nl sales 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 Authanzed 5ignatute equipment, whichever amount is greater. Nate: 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, ay c9pcel this transaction at any time prior to midnight of the third business day after the date of this transacti n. anc lation must be done in writing. i AO, G i S CONTRACT IF THERE ANY BLANK S CES. Sianature Date Sianatwe \ Date 3l I ... _x -A IMPORTANT INFORMATION ON BACK P The Commonwealth of Massachusetts - Department of Industrigl Accidents Office of Investigaflons 600 Washington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: BuRders/Cont°actors/El.ectricians[Plumbers Applicant Information Please Print Legibly Name (Business/Organization&dividual): .'o-eVl Address: 0r City/State/Zip: ► 4APhone �� f �"5 #: 9% r i© —,5 2-6 / Are you an employer? Check the appropriate box: [g I am a employer with )-- 4. ❑ I am a general contractor and I .1. employees (full and/or part-time).* have }fired the sub -contractors 2. ❑ I am a sola proprietor or partner- listed on the attached sheet. t ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ 1 am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] ► employees. [No workers' comp. insurance required.] Type of project (required): 6. [ New construction 7. Remodeling 8. Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.Q Roofrepairs 13.❑ Other *Any applicant that checks box41 must also fill out the section below showing their workers' compensation policy information. T -Homeowners who submit this affidavit indicating they hire doing all work and then hire outside contractors must submit anew 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. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. — i Insurance Company Name: S 1y�5L)rc�,n Policy # or Self -ins. Lia #: f ' \- 2-1*xpixatronDate: i Job Site Address: ! City/State/Zip:, �t1 i� Attach a copy of the workers' compensation -policy iieclaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL o. 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 $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Officeof Investigations of the DTA for insurance coverage verification. • I do Hereby certify un flee pa' s an enalties ofperjury tliat the information providedab ve its true and correct. 3 Phone #: "? 8 6 4 i- 5 Zy i Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. EIectrical Inspector 5. Plumbing Inspector 6. Other - Contact Person: Phone Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License: CS -058245 KENNETH B KE" 21 HEWITT AVE: t N ANDOVER MA 01k, `\ Expiration Commissioner 03/24/2016 Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS -076691 J ROBERT A KEEN-` �. 12 E WATER ST North Andover MA 0 {,rti Expiration Commissioner 08/16/2015 Office of Consumer Affairs & Business Regulation ME IMPROVEMENT CONTRACTOR egistration::`-08383 Type: e xpiration: 8/1B/ 01g DBA KEEN CONSTRUrTI'n Kenneth Keen r 1175 TURNPIKE ST 1`' �-=- N0. ANDOVER, MA 01845 Kf" Undersecretary 11/13/?014 10:00 FAX 781 942 2226 GILBERT 10001/001 .�►Co CERTIFICATE OF LIABILITY INSURANC� .iiiii201 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED SY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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 lS WANED, 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 aertlflcate holder in lieu of such endorsemengs) PRODUCER =,^u' Barbara McDonough Gilbert Insura oo Agency, InC:. !MN& 0a (781)942-2225 111701) P42-2226 137 Main Street AnnRL gss:bmcdonoughlg:Llbortingk=anre.com Reading MA 01867-3922 INs R NORFOLK ro DEDH M INS CE , INSUREv Har ord Fire Inawance Com g Keen Construction Company 1N8JJRMc,Trav01er5 Insur Ce 1175 Turnpike Street INSURER D ' ' MA, 01845 OVERAGES CERTIFICATE NUMBER:CL1441500922 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURI INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM. TYPE OF INSURANCE ADDL SUOR POLICY NQMBER IMPo EFFLTR Y EXP GENERAL UABIUTY X COMMERCIAL GENERAL LIASIL" A CLAIMS -MADE ❑X OCCUR -P-010078/000 /13/2014 /13/2015 GEN'L AGGREGATE LIMIT APPLIES PER: D$S=P,nON OF OPERATIONS / LOCATIONS I VEHICLES (AVath AOORD 101, Add Wonal Rem 9M schadule, R We apace Ie mqW ad) Evidence of coverage omnQlnu u4 uupcQ. A NAMED ABOVE FOR THE POLICY PERIOD AUTOMOMLE UAINLITY HEREIN IS SUBJECT TO ALL THE TERMS, umk Is ANY AUTO ALL ED }i 5CMEDULED D RBowmrINTku 100,000l UVECAA6432ALJ 2/3/2013 MED EXP (Arly, elm an) LO$ PER ONAL & ADV INJURY , 10000 000 GENERAL AGGTE I S 2, 000,000 PRODUCTS - COMP/OP AGGI X HIRED AUTOS AUX NON -OWNED ,S -`CQM8INFD SIN01.9 LIMIT:L.000,000 BODILY INJURY (Per par -an) I S UMBRELLA LIAR OCCUR BODILY INJURY (Per awdenl) $ OP 3 ndarinswW =10MI 3100,090 EXWSS LJAS CLAIMS4W EACH 00CLIRRENCE I 3 AGGREGATE S ED RETENTION WC TA - OT11- L'MHA0010ENT 9 1001900 C WQRKERSCOMPENSATION E.L. DISEASE -POLICY LIMB S SQ0,000 To be Provided directly AND 04PLOYERS' LIABILITYI N ANY PROPRIETOR/PARTNr:P4XECUTN& is the carrier. OFFICER/MEMBEREXCWD£09 NIA 0/9/2014 D$S=P,nON OF OPERATIONS / LOCATIONS I VEHICLES (AVath AOORD 101, Add Wonal Rem 9M schadule, R We apace Ie mqW ad) Evidence of coverage omnQlnu u4 uupcQ. A NAMED ABOVE FOR THE POLICY PERIOD )OCUMENT WITH RESP90T TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, umk EACH 02JURREN09 S 1,0 0, 000 D RBowmrINTku 100,000l IF MED EXP (Arly, elm an) 6,000 PER ONAL & ADV INJURY , 10000 000 GENERAL AGGTE I S 2, 000,000 PRODUCTS - COMP/OP AGGI 2 , 000, 000 ,S -`CQM8INFD SIN01.9 LIMIT:L.000,000 BODILY INJURY (Per par -an) I S BODILY INJURY (Per awdenl) $ OP 3 ndarinswW =10MI 3100,090 EACH 00CLIRRENCE I 3 AGGREGATE S S WC TA - OT11- L'MHA0010ENT 9 1001900 EL DISEASE - EA EMPLOYEq S 109,000 E.L. DISEASE -POLICY LIMB S SQ0,000 (978) 688-9542 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BEICANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. i Town of North Andover 1600 Osgood Street 7UTHORI7,.BD REPRESENTATM North Andover, MA 01845 M Gilbert, CIC/RARHAR ACORD R(250101/05) ®1888.2010 ACORD CORPORATION. All rights reserved. ,&Soma „,,.— n. Tha ACORD name and logo are registered marks of ACORD I