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HomeMy WebLinkAboutBuilding Permit #441 - 498 OSGOOD STREET 12/19/2007 NORT�y BUILDING PERMIT o* TOWN OF NORTH ANDOVER. c APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received SgcHuSAT ���y Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print _ PROPERTY OWNER Print MAP NOVO Z PARCEL: 0 2 ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 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 DE CRIPTION OF WORK TO BE PREFORMED: ►2 Lydo %0 V /V TS - Identificaj'gn Please Type or Print Clearly) OWNER: Name: `�i��y 1�A2 b,g 2 A a 9,of0il6C Phone:�7�f•ZJ��--7?6 V Address: ,S o0 4 S1 , CONTRACTOR Name:_ % �S-,0o L/It.y 34. Phone?;?7�-G 9 !- Za } Address: _ 2 1 HIL r i rr y ?N C(• ✓ Supervisor's Construction License: �� ? S Exp. Date: :3 Home Improvement License: t5 3 3 Exp. Date: <k 1 � ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. 00 Total Project Cost: $ Z l (0 6 FEE: $ Z 6 0 0`9' Check No.: �52 o I Receipt No.: w4----�Z- NOTE: Persons contracting with unregistered contractors do not have access to the gqqrantyfund Signature of Agent/Owner Signature of contracto T x i 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 DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH 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 Driveway Permit Located at 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.$100-$1000 fine NOTES and DATA— For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 � T 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 t Revised 2.2007 NORTH TO" over C - V No. ij o ;_= © _ dover, Mass., /a /9 'D� � C OC MIC MEWICK IV oRATED 7v 4` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System �j � BUILDING INSPECTOR THIS CERTIFIES THAT..J ..... A:....... r�. ..Q... ......................... .............................. ................................. Foundation has permission to erect...... .............. .............. buildings on ... ....YS......� .. . 0 ..... ........... ..... ..................... Rough to be occupied as.......��i .......... ......... ......1��..T....... K�-r......................................................... Chimney provided that the person a cepting this ermlt 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU N ST TS Rough .......... . ... ...................................... ..................... "'!! Service BUILDING R 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. ,............ a� �'l e -F'a�n�rna7uuea� o�/�.�zaarcc�ivaeCla � Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registrti9nt 108383 Ex��raEton 8/18/2008 r is r -� pDAl KEEWCONSTRI�C 0101 C!0 �. E f i Kenneth Keen 21 Hi�wit:t Ave 'I No An "Over,TNA 01845" Deputy Administrator Gl�ie,C�arrimwnzcueaC �� aaTu4ael : BOARD 05BUILDIN `A5,00,L�ATIONS' i t z icgnS.Q GONSTRUCTION`Sl9PERVfSOR NSmberS 058245 �'+ uthdate 03/24/1943 t13�24r?f(�8 Tr no: 13436 M 4Bes 11Cedr}0 K � 10EE43� + ' %f 4� ___ —.-- The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston,MA 02111 f M s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /1 Please Print Legibly Name(Business/Organization/Individual): K E E XJin ei Address: 7 IldE City/State/Zip: /IIIA Phone.#:� Are you an employer?Check the appropriate box: Type of project(required):. 4. I am a general contractor and I �� 1.® I am a employer with ❑ 6. New construction employees(full and/or part-time).* have hired the sub-contractors ❑ 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. employees and have workers' Y .addition Building9. , co insurance.$ ❑ workers comp. comp.[No insurance 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P . 3.El officers have exercised their I am a homeowner doing all work 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 Homeow-ners 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: 6 a to e—t t c S4 fl 4 E ;Z::,pi S ' Policy#or Self-ins. Lic. Expiration Date: /d Job Site Address: Y�g ®�9�bG� s2� 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. Ido hereby certifF under the in and penalties of perjury that the information provided above is trues and correct. Sianafore: Date: Phone#: Off cial 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 ContactPerson: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." ' An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal,entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the.occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"ever state or local licensing agency shall withhold the issuance or renewal of a license or permit to,6perate7a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that ibis affidavit may submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple pen-nit/license applications in any given year,need'only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone'and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 1122-06 www.mass.gov/dia VY/LY/GVV1 11.JV a-nl► 1OL OYL f.GLV VaLuaui�a a .s�a�nivLi - .�VV� PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Gilbert Insurance'Agency Inc HOLDER- THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 137 Main St , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Reading,MA 01867.3922 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Kenneth Keen&Robert Keen 21 Hewitt Ave North Andover, MA 01845-0000 IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING AMI REQUIREMENT,TERM OR CONDITION OR ANY CONTRACT OR OTHER 'DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDEDTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PIC D CLAIMS, 00 LTR TYPE Or INSURANCE POLK.11NUMBE POLICY EFFECTIVE DATE POUCYEXPIRATIDNDATE , A SAT IDNI EMPLOYERS'LNBILITY LIMITS PROPRETORI PARTNERSIEXECUTWE OFFICERS ARE: IN 0 EXCL 0ME10668 8/03/2007 8/03/2008 STATUTORYLIMITS TMER erape Appllee l a MA OPwdcnz ONy. ACCIDENT s 100,00 ISEASE POLICY LIMIT $ 500,00 ISEASE-EACH EMPLOYEE $ 100,0010 ESCRIPTION OF OPERATIORdiiVENCLEM AL ITEal1S RE ROBERT KEEN IS COVERED BY THE WORKERS COMPENSATION POLICY AND KENNETH B KEEN IS NOT COVERED BY THE i RKERS COMPENSATION INXICY. CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHB EVIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 19 -1600 OSGOOD ST DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT `NORTH ANDOVER,MA 01845 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENT'S OR REPRESENTATNES, AUTHORIZED REPRESENTATIVE I 1 VV/1V/ rVVI LV.�L a(lal i VL V96 br4V Va uua.,a\a aa.Vta�a)„Vaa .r.IVVV DATE IMM(PINYM AD= CERTIFICATE OF LIABILITY INSURANCE 09/13/2007' AD= PRODUCER (781)942-2223 FAX (781)942-2226 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Cil bent Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 137 Main Street ALTER THE COVERAGE AFFORDED BY THE POLI IES BELOW. Reading, MA 01867-3922 INSURERS AFFORDING COVERAGE MAIC# INSURED Kennet 8. Keen Robj!rt Keen INSURER A; NORFOLK & DEDHAM INSURANCE 23965 DBA: Keen Construction Company INSURER B: 21 Hewitt Ave. INSURERC North Andover, MA 0184S INSURERD_ INSURER E: 0YERAGE5 THE POLICIES OF INSURANCE LISTED 9ELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDIN ANY REQUIREMENT.TERM OR CON0114DN OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 SHOWr.J:MAY HAVE BEEN REDUCED BY PAID CLAIMS. rA DO' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY ND-P-010078/000 03/13/2007 03/13/2008 EACH OCCURRENCE $ 1,000,0O X COMMERCIALGENERALLIABILITY OAMAOETORENTED E 50,00 4RF/J1�'C�'IFS nrrLrM CLAIMS MADE a OCCL R MED EXP(Anyone person) S S QQ PERSONAL 6 ADV INJURY 3 11000,000 GENERAL AGGREGATE S 21000,00 GEN'L ACGREGATE LIMIT APPLIES F ER; PRODUCTS•COMP/OP AGG S 2,000.00 _ ri POLICY 1PFRC0j LIA: AUTOMOBILE LIABILITY COMBINED SINGLE UMIT ANY AUTO (Es accldenl) S ALL OWNED AUTOS BODILY INJURY 6 SCIiEOULED AUTOS (Pel Person) HIRED AUTOS BODILY INJURY NON-0WNED AUTOS (Per accident) S PROPERTY DAMAGE s (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER TMAN EA ACC b AUTO ONLY: AGO S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE S - OCCUR F1 CLAIMS MATE AGGREGATE S i DEDUCTIBLE S RETENTION It 1 WCSTATV OTH- WORKERS COMPENSATION AND MDR EMPLOYERS'LIABILITY E.L.EACH ACCIDENT S ANY PROPRIETOR/PARTNERIEXECUTLVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE•EA EMPLOYEE S 11165 describe under W 1114 describe PROVISIONS below E.L.DISEASE•POLICY LIMB 5 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS I VIIHICLES I EXCLUSIONS ADOED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLD R CANCELLATI SHOULD ANY OF THE ABOVE DESCRIBED POUCIE,S 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, Town of North Andover,' BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY 1600 Osgood Street - OF ANY KIND UPON THE INSURER S AGENTS OR REPRESENTATIVES. North Andover, MA 01.E:45 AUTHOR99D REPRESENTATIVE Dawn Cram 4io__i I ACORD 2S(2001/08) FAX; (9711)682-3231 ®ACORD CORPORATION 1988 KEEN CONSTRUCTION CO. 21 HEWITT AVE. N. ANDOVER,MA 01845 .(978) 69111-5201 Graovac,Dan,&Barbara 498 Osgood St: N.Andover,.MA 018.45 (978):258-7764 Contract# 1693;Appendix A Date:1.1/25/07 Window-replacement: • Supply&install.six Pella Architect series windows with.exterior clad, '.rimed interior, , Insulshield glass, 7/8".SDL muntin bars:;(double hung top sash only) All casements to have roll screen, double hung full height standard screen Satin nickel hardware • Ank.exterior-casing, 5/4"x"flat casing and sill nosing Interior trim to match existing V : Windows included: - - ,w Dining room: triple casement&single casement Living room: special arch top over.double casement • Foyer:single casement • Bonus room: triple casement&one,double hung Total price:$21,696.37(twenty one thousand six hundred ni ty six and 37/100 dollars) Price includes six days(two men)`labor-and dumpster. �-' Price does not,include cost of permit,rotted frame or sheathing,cedar siding,or any painting. Payment schedule:$.7000.00 due upon signing contract $7000.00 due when windows are delivered $2500:00 due the first day of work - i $.5,196:37 due at°completion of contractedwork f Customer Ke' Keeri ° Date Date MV KEEN CONSTRUCTION CO. ° 21 HEWITT AVENUE rROPOSAL NORTH ANDOVER. MA 01845 Tel: (978)691-5201 All home improvement contractors and subcontractors Fax: 97 engaged in home improvement contracting, unless ( 8)682-3231 9 specifically exe m pt from registration by Provisions of i Chapter 142A of the general laws, must be registered with Submitted I i i the Commonwealth of Massachusetts. Inquiries about To: f+r�`� I )e�'._ 1r��i<< ,i- �c.C;�, q t .. registration and status should be made to the Director, .aC ) Home Improvement Contract Registration,One Ashburton �Jl Place, Room 1301, Boston, MA 02108 (617) 727-8598. _...- _ _ ..........-. /`�' Owners who secure their own construction related ........ ' -f_. `1�.�...) ,, �� . ��,��.L _ ._._ 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.NO.)27 S-„ I1MA. H. C. 108383 _04=.32.5.=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: _ .... t ....... ._...._........ > Construction related permits. .......................................................................... ill C( 1, f r 1 is firs f WORKSCHEDULE ............... ..................................................: ....................... Contractor will of 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 b wner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that aPe not avoidable by the Contractor shall not be considered as violations of thhiis 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 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 Contracto,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 specifi atios, for the sum of r;f} 1 x CJ / f?6"dollars($ Payment to be mode as follows: , f ), % ($ ) upon signing Contract; KENNETH B. KEEN Name of Contractor/Designated Registrant ($ ) u oa,�t4m I�tiQ�of 21 HEWITT AVE. {! to °� Street Address � o � Luon N. { � ) p completion of _ ANDOVER, MA 01845 o� ($ ) shall be made forthwith upon City/State (978) 691-5201 (978) 682-3231 completion of work under this contract. Pt one - . .. - -. 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 n!Salesman 1 z_ or the total amount of all deposits or payments which the contractor must make, in f j advance, to order and/or otherwise obtain delivery of special order materials andAuth� edgna ureT equipment,whichever amount is greater. w- Note: This proposal maybe 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. 0 NOT 'IGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. 4 Signaturern Date Signature Date IMPORTANT INFORMATION ON BACK ► Location` of No. Date �� �aRTM TOWN OF NORTH ANDOVER 0AL .« 10 ` y Certificate of Occupancy $ • � : , Building/Frame Permit Fee $ s�CMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 0)0 20872 - Building Inspector