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HomeMy WebLinkAboutBuilding Permit #821 - 54 SPRING HILL ROAD 6/20/2006Ice t Mp eTM , it a p� ,SSNCHUSE4 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN E?�.�I�ATION Permit NO: v I Date Issued: IMPORTANT: App t LOCATION PROPERTY OWNER� l � >VtAP NO.:%�6 .PARCEL: nr'&7"lr A !1C WITil "rvrV Date Received. �'-f�-cs 4 - icant must complete all items on this Tint yiv nJ e -v LA -) M, rint ZONING DISTRICT: UKTnUIC inCTR1CT VF.S ❑ 1 11 L Aa�v v TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential .i New Building W-6ne family �1 Addition -. Two or more family L Industrial i,<teration No. of units: Li Repair, replacement L Assessory Bldg C' Commercial C.' Demolition L Moving (relocation) L Other L Others: - Foundation only DESCRIPTION OF. WORK TO BE FREruKmEv R Nr 641C �-, r niS �n� G Identification Please Tyne or Print Clearly) OWNER: Name: C a W YY1 r 1. (� N Phone"??i' Signature Address: - CONTRACTOR Name: ?1` tone:6011-S?-01 Address: 1 W L, -4i r _�y F - Supervisors Construction License: Exp. Date: 4> b , Home Improvement License: 10 q � 4 3 Exp. Date: $Q— ARC1-11TEC'T FNGINEER Name: Phone: Address: Reg. No FEE SCHEDULE: BULDING PERMIT: $10.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $' 115.00 PER S.F. a Total Project Cost 3 19 ©3o xI0.00 FEES � -hw Check No.: ,i/� 2 Receipt No.:-„�' A(& 'TYPE OF SEWARGE DISPOSAL Zarin ing/kIassagei Body ArtSwimming Pools Public Sewer ✓ , ,1 `-,� _ Tobacco Sales_ Food Packaoino;Sales Well' � Pernianent,Dumpster on Site Private (septic tank, etc. NOTE: Persons contracting; with unregistered contractors rlo ihot have access to the l;hharant)7 riuhrl Sinature. of Agent/'Owner- Si��nature of Contract Plans Submitted P1ans,Waived. ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS CONSERVATION' COMMENTS a HEALTH. COMMENTS DATE REJECTED DATE APPROVED ❑ ❑ ; DATE REJECTED DATE APPROVED. Zonin-.Board of Appeals: Variance, Petition No: Zoning Decision:receipt submitted yes _ plannins, Board Decision: Comments Conservation Decision: Comments Writer Scbb•er connection si(Inature & date Temp Dempster on site yes _no_ Fire Department signature,'date Building Permit ,approved and Issued by: Building Setback Front Yard aired I Provided DIMENSION Number ol'Stories: Total land area, sq. ft.: Side Yard -Cu i r:e d:: Provides Rear Yard , uired �— Provided Total square feet of floor area., based on Exterior dimensions. 'VIF 1"K J."I r- 17 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 ❑ Debris Removal Form ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o. Copy of Contract ❑ Floor Plan Or Proposed Interior Work . Addition Or Decks ❑ Building Permit Application ❑ Form U ❑ Surveyed Plot Plan ❑ Debris Removal Form ❑ 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 Pen -nit Application f ❑ Form U ❑ 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 Hydraul!c Calculations (If Applicable) ❑ Copy of Contract j ❑ Mass check Energy Compliance Report I In all cases if a variance or special permit was required the ?own Clef -lis office must stamp file 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 SERV ICES DEPARTIIE\T:13I1FOR.\I05 Er 10 W loo i7 6 Q C C p C y O O �r m m CD CD O O p L- Q o a c� O Cc •y Z ; CD CL �..± h � C CL C C CO) LLI Y/ W W 19 W U) u b wO c o • 94 U � Or. C m c C4 O w Oar no C W. w po o� no w ca w �r x W v a o 2 n Q ae O �x04 loo i7 6 Q C C p C y O O �r m m CD CD O O p L- Q o a c� O Cc •y Z ; CD CL �..± h � C CL C C CO) LLI Y/ W W 19 W U) c o • m c o� 16, O y . C O Cc G.3 •dam nc ...: c c c :=CD o I iN, ;o` E m o is o a EE c :o 43 0 me E y AC� � mm cm3 C;j 1► cm z y 0 _ m c OGo O ED ia�� m Z r O vi o a �_ _c y z o o � cc H V Z C Ce O O co O C C = o :mL. 3 N Z •tyi� .. ID f.. W E Qt"c S-0.� Z 'O h a • O _ � a ` O F-• = C36.=v, loo i7 6 Q C C p C y O O �r m m CD CD O O p L- Q o a c� O Cc •y Z ; CD CL �..± h � C CL C C CO) LLI Y/ W W 19 W U) KEEN CONSTRUCTION CO. 21 HEWITT AVE. N. ANDOVER, MA 01845 (978),691-5201, Gillen, Bill & Lynne 54 Spring Hill Rd. N. Andover, MA 01845 (978:)' 582-4927 Contract # 1624; Appendix A Date:6/13/06 Laundry: • Frame laundry area in basement (approx. 6'X 14') • Insulate exterior walls - Supply & install blueboard and skimcoat walls to smooth finish • Remove existing door and install in opening to boiler room • Supply & install one 3'0""x 6'6" hollow core smooth Masonite door unit into laundry room Move existing A. C. ducts to boiler room • Remove ceiling and open walls in family room to facilitate plumbing to existing stack • Repair ceiling and walls as ineeded • Supply & install trim on doors and base to match existing • Supply & install 2' x 2' revealed edge suspended ceiling • Rehang alarm control box on wall- surface Supply& install vinyl flooring in laundry room ($500.00 installed allowance) Plumbing: • Supply &install laundry pump and all plumbing required • Supply & install laundry valve and.," plumbing required • Supply &. install gas valve for laundry and all plumbing required Wet Bar: • Remove existing door and frame.bar area Insulate, install blueboard and plaster as needed • Install customer supplied cabinets Supply& install. trim to match existing • Install customer supplied bar refrigerator Plumbing: • Supply& install plumbing for wet bar sink • Install customer supplied wet bar sink and faucet Price does not include electrical work, cabinets; counters, sink, faucet; appliances, flooring in wet bar or permits. s Total Price -$19;030:00 (nineteen thousand.thirty dollars) KEEN CONSTRUCTION CO. 21 HEWITT AVENUE NORTH ANDOVER. MA 01845 Tel: (978) 691-5201 Fax: (978) 682-3231 Submitted.. To: i r.. ... ....... ............ . ...... . ............. 1624 All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from, registration by .Provisions of Chapter 142A of the general laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02108 (617) 727-8598. 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. F.I.D. N0. Q`)2 ^% MA. H.I.C. 108383 04-325-8052 > C/S = Customer Supplied S + I = Supply+ Install We hereby submit specifications and estimates for work to be performed and materials to be used: C_ > Construction related permits: r 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 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 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 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 specifications, for the sum of I I' ✓tct i The Commonwealth of Massachusetts �_ 1716 De artment o Industrial Accidents l �, 4 - i :_ Office offnuestigations _.: 7 600 Washington Street, 7'l' Floor Boston Mass. 02111 : , Workers' Compensation Insurance Affidavit Building/Plumbing/Electrical /Elech real Contractors Applicant m/for matron': 1°> -.:' / Please PRINT legibly L1 D7 (, 1 I►— W address: "Z. II H Lug f 7T 14 tri � �+ ,�[; city P r ITdo o tiIe• state: ✓11 t zip:C)A Y� phone # � lI(� ' � Lf I am a homeowner performing all work myself. Project Type: ❑ New Construction ❑Remodel [�1 am a sole proprietor and have no one working in any capacity. ❑ Building Addition ❑ I am an employer providing workers' compensation for my employees working on this fob. company name: city: phone #• ❑ 1 atm 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: city: phone #• Insurance co olio # company name: city: phone #• insurance co. policy # Attach,addidonal sheet if necessary 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 certify un ter the pains a peqalt�m ofpe,jtuy that the information provided above is true and correct. Signature it �. Date •- `C�� Q 6 Print name � /V At L`� r IS �� Phone # of �^ s:.h1'#Y.t,,.f official use only do not write in this area to be completed by city or town official S `ol . A city or town: permit/license # ❑Building Department ❑ check if immediate response is required ❑Licensing Board ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised Sep. 2007) y ,,. ,:: :.-. .,%A.....,.. . ..-.. i.':]y1,5.�. ..'r :.::�f..:, r,'.'I.iS''1' .r ..1::'• .::it 3 ��e -COomvnaonu�ecL/,�L o�✓vca°°aciLuael�a " Board of Building Regulations and Standards s F.y HOME IMRROVEMENT.CONTRACTOR s i Registrati6n \ 108383 E: Dion?}18f 2006 { KEEN CONSTRUC 'CONIG Kenneth Keen / r 21 `Hewitt Ave... rim j ✓ �No. Andover, MA 01845 Administrator t; w ✓ 7 O �!'vI,CL(IO(lCiLL7,6P�b . r 69I7/i)ZO�ItLUPq/�/ BOARD OF BUILDIN�REGULA TdONS . . icense: CONSTRUCTION SUPERVISOR Number.CS 058245 =a. . �~ t 31rthdate 03/24/1943 Expires o3/24/2008 ...;er.*.... _ r•c't a x` Vii..' Tr no13436; j - Restricted' d0 � ;; xxr a KENNETH=B 21HEWITTAVE i�� /! _ N i4NDOVER :MA 01845 Com,, Commissioner r 7-77 r. _a _ ______f is I� N ---� Gi— Location No. 1 Date /4 -2.0 - o G TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ J'CNUSE<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ s TOTAL $ Check # 372!272— , Building Inspector