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Home My WebLink AboutBuilding Permit #1264-2016 - 60 WINDSOR LANE 6/15/2016 BUILDING PERMIT NORrN w. O��t LED 6�•r� `� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION 70 -Il�v Date Received Permit No#: / Og17E0�° 4`� gSSACHU`�� Date Issued: IM ORTANT: Applicant must complete all items on this page LOCATION 6 (&r'n alSUr Lh V0 ( Pr* t PROPERTY OWNER E� V-b 0 ( 1 oGk Print 100 Year Structure yesi MAP PARCEL:_ZONING DISTRICT: Historic District yes Machine Shop Village yesi1 TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial 0 Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑ Wetlands ❑ Watershed District ❑Water/Sewer r DESCRIPTION OF WORK/TO BE PERFORM D: �v1 S�rVt d1 y �o�CS yr uc��rn ?c L 3 ✓�' -Fra i Svn ►' -�, I A J[deptific tion- Please� ype or Print Clearly OWNER: Name: Q-- 4 Phone: Address: (60 Wl*t-d5.S 7 Lo k, 94 cfdg-r !� Contractor me: r GT`�^ Phone: ' �9/-�Za Email: 5,:::;7e -'A rc 7 e-o ► Wt Address: PO 6o n 9357 , X? a-ver �' Supervisor's Construction License: Vis_ 6766,9 1 Exp. Date: / (6 �f 7 - Home Improvement License:. 16$3Ss 3 Exp. Date: <Z/1 '9 11.4 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED.COST BASED ON$125.00 PER S.F. Total Project Cost: $ �J� 3(S FEE: $ fl • L-ro Check No.: ` 1� Receipt No.: �O NOTE: Persons contracting wilh unregistered contractors do not have access to e r fund - ---- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanuing/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ rivate(septic tank tc. Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS . I CONSERVATION Reviewed on Signature ` COMMENTS +V\ O o EALTH Reviewed on I Signature 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE+DEPAR�TMERIiT TeMP 11) nester gn,%ite; eyes Ino, Fire,Departmentsignature/dafe: 'C OMMENTS 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: lies No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) J LH E ax"" �- �f e-&I '-� ❑ Notified for pickup Call Email 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 OTE: 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 4. 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 OTE: 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 ,rF 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 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: 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 Doe:Building Permit Revised 2014 Location (. -0 `»fZ- LrJ No. \2-coli `! Date G h`7 b70 � i r t • TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $`+f b Foundation Permit Fee $ Other Permit Fee $ t TOTAL $ Check# • . '= It, -) `��ilding Inspector L/� r 'i NORTII _ . w: 1 . �� _ ic . " ve' . O ;' p► No. VID L^'KE h ver, Mass, wk 16 lit COC MIC HI W IC. 'ls.9s RATeo V BOARD OF HEALTH Food/Kitchen PERMIT, L D Septic System THIS CERTIFIES THAT ..... BUILDING INSPECTOR 0. (AA.QLW..LA.!.................... Foundation has permission to erect .......................... buildinVs on ... 11 Rough to be occupied as ................................. Chimney provided that the person accepting this permit shall in every respect con rm 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 CONS-TPKTIO Rough Service .. ..... .. ... ..... . ..... ............. Final BUILD G IN PECTOR 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. - 7 REM(1UELIPI C: SPEGIALIS'1'S' 978-697-5207 KeenConstructionCo.com Zablocki, Ed&Val 60 Windsor Ln. N.Andover, MA 01845 Contract#5801;Appendix A May 20,2016 Existing deck:$16,718 • Remove and dispose of existing deck • Frame deck to code with same footprint as existing • Create two stairways • Supply& install Azek XLM Mahogany decking and Timbertech Radiance Rail system • Wrap deck in PVC trimboards Finish inside of sunroom:$16,650 • Supply& install electric radiant floor heat in entire room • Supply& install tile floor($5/sq ft allowance) • Supply& install insulation to code • Supply& install W blueboard and skimcoat plaster to smooth finish • Supply& install trim on windows and base to match existing • Paint walls,ceiling and trim Total Price: $33,368(thirty three thousand three hundred sixty eight dollars) Price does not include cost of permits or repairs to any unusual, unsafe or non-code compliant existing conditions not addressed in this quote. Payment Schedule: $5000 due when existing deck is demolished $5000 due when deck is framed $6000 due when deck is complete $6000 due when electrical is complete $6000 due when trim is complete $5368 due when contracted work is co le ,�f -r? ustomer Robert Keen 0.4 Date Date PO Box 935 Page 1 of 1 P: 978-691-5201 N. Andover, MA 01845 F: 978-682-3231 CSL#076691 Sales@KeenConstructionCo.com HIC#108383 580 -114 KEEN CONSTRUCTION WO� A X 935 ■ ROPOSAL NORTH ANDOVER; MA 01845 All home improvement contractors and subcontractors Tel: (978)69-1-5201 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 d \(Q �S �IGGI/t with the Commonwealth of Massachusetts. Inquiries yy v� about registration and status should be made to the Director,Home Improvement Contract Registration,10 ✓ JcN� Park Plaza, Room 5170, Boston, MA 02116 617-973- q 8787 Owners who secure their own construction J 1 C\kfr. /i l 1 I n 7 related permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c.142A. PHONE DATE REGISTRATION NO, EIN N0. SIZU L2MA. 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�k4� stm rt�r See, 40up14 x I > Construction related permits: ........._..._....__._..........._....._..__..__..____.`_......................................................................................._._._..........._..................................._. WORK SCHEDULE __._........................._. . ._...._...................... Cont ter ill not gin the work or order the materials before the third day following the signing of this Agreement,unless specified here in tin Contr ctor will begin the work on or about (date). Barring data caused by circumstances beyond Contractor's control,the work will be completed by 1 (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 n 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 Contract ,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 7k ;Tfivee 1 iC)l�,LC,0 (J Jb re P_. �t Vl(� �Q Jt X� i Fi:,h � -- dollars($,3 3, �e C O ). Payment to beimade as follows: % ($ ) upon signing Contract; ROBERT A. KEEN Name of Contractor/Designated Registrant % ($ ) upcompletion of Pb ��9 3 I � ( I I Street Address /e ($ ron.completion of N. ANDOVER, MA 01845 City/State L� ($ ) 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 arae +41.prna. I I or the total amount of all deposits or payments which the contractor mustmake, advance,to order and/or otherwise obtain delivery of special order materials and AutKodz&d sighaturet 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 IGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. SignatureDate Signature Date IMPORTANT INFORMATION ON BACK i I -I The Commonwealth of Massachusetts Department of Industrial Accidents i - d 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia bv' Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Letribly Name(Business/Organization/Individual): 4en 5A ry C- , rv-\ Ca Address: 1 n ,A,�' '• fl/� City/State/Zip: �� 1��1 'L Ir I G f$P one#: �— (1r 9'+ 572,0 1 Are you an employer?Check the appropriate box: Type of project(required): 1.21 I am a employer with 2- employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp,insurance required.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole ME]Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 14. Other 6.Q we are a corporation and its officers have exercised their right of'exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box 41 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: �f��. e5 / 5 — Policy#or Self-ins.Lic.#:614L) B —922 1 H?,—z — \�'S Expiration Date: 1 Job Site Address: ( `te (�l n City/State/Zip: � C Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify d the ins and penalties of perjury that the information provid�e~d above is true and correct. Si nature: Date: J Phone#: EEOther only. Do not write in this area,to be completed by city or town official. n: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: Massachusetts -Department of Public Safety Board of Building Regulations and Standards Vcwist1 ucfion1 supel Visa License: CS-076691 ROBERT A KEE1�-` 12 E WATER ST 19 $ North Andover NR 0 Y \� Expiration Commissioner 08/16/2017 � ��-e�a,»rir�aa�acueall,�a�C�/�cca�ac�uaeCYt. fee of Consumer Affairs&Business Regulation E IMPROVEMENT CONTRACTOR egistration:,-108383 ;a Type: Expiration `8!181201'6 Supplement Ca KEENCONSTRUCTION:_CO f. __ ROBERT KEEN 1175 TURNPIKE ST ; y , NO.ANDOVER, MA 01845 Undersecretary