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HomeMy WebLinkAboutBuilding Permit #866-11 - 80 SETTLERS RIDGE ROAD 6/15/2011Permit NO: '46 —�� Date Issued: BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received &— , a o•,�s,.�o , 6� ti� T i ~ D- ca«ii«iwc« - �• TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building --One family t—Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well -Flood"plain W-etlands Watershed District Water/Sewer.._ DESCRIPTION OF WORK TO BE PREFORMED: ,S c 2 g C' 'J Q o oI'V\ R .J �L `P e..q L., + r,!k S Identification Please Type or Print Clearly) y ` IC OWNER: Name:_ _K5 ! I 6F • .TSae� Ks--jui T Phone:,,?9 Address: % b - S E -V / r^,z. c (2-, � 9C` (2 A ARCHITECT/ENGINEER Phone: 1 Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ c3o-�. ®6 a FEE: $_ Check No.: 4; �� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the gu �anty fund SgnaturKOf AgentlOwner Sigriature`of contractor . 1 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL ublic Sewer L ' 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 COMMENTS CONSERVATION Reviewed on COMMENTS HEALTH COMMENTS DATE REJECTED DATE APPROVED Reviewed on Siqnature Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: ,` Conservation Decision: Comments Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENTTemp -Du mpster on site yes Located.at 1:24 Mbin Street 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 NOTES and DATA — (For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2010 No 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 K.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.G.. 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 2008 Location No. D ate Check #6 7 0, �/' 2 4 �-'/ 6 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ v A iff " 16uilding inspector O � Cd w O r CD c� o ` c y : O ' c r O V V C. C O W CDCD c pis _cc N O><'d mCE CD u Q 0 CD v `�.1 ¢u w �i• : O C. it o E C 1 Q t0 D G0 O mcm c N O cm a � = c A v • N m E ,o CCD LV L N m O �; •rC�.. y.Q 0.2 CH y Z. • c r0.. O C. O Q O W.m c = mwm m ,, p C. 4- N O a i -- W c0 .O 'O L ,r c +- •GO co ui = O.t ea c +"' •N V •® p O c_ y C. 4D O � 2 ea .a o h E— = C:, I- O O :U :W A '^ Cl) cm w O v' �p O O U v cn v Z W •� O W -a. 1� p C� O co . O O v z °' D. O y C I C � 'w O ■� Q y O O 'CD cc ts g m m CL .0 O.D � D o. e_v o a E: ora c co) c V\Y J 'O C z CD 0 CL V CO) C C CO2 W vI W W O OU W O w' A Q T u p a o GQ b .0 cy U w id w W u W i0 w 7 is w w. o Q Z v v .�. s4 O w° cin w2 a°' co w°' rA cn cn CD c� o ` c y : O ' c r O V V C. C O W CDCD c pis _cc N O><'d mCE CD u Q 0 CD v `�.1 ¢u w �i• : O C. it o E C 1 Q t0 D G0 O mcm c N O cm a � = c A v • N m E ,o CCD LV L N m O �; •rC�.. y.Q 0.2 CH y Z. • c r0.. O C. O Q O W.m c = mwm m ,, p C. 4- N O a i -- W c0 .O 'O L ,r c +- •GO co ui = O.t ea c +"' •N V •® p O c_ y C. 4D O � 2 ea .a o h E— = C:, I- O O :U :W A '^ Cl) cm w O v' �p O O U v cn v Z W •� O W -a. 1� p C� O co . O O v z °' D. O y C I C � 'w O ■� Q y O O 'CD cc ts g m m CL .0 O.D � D o. e_v o a E: ora c co) c V\Y J 'O C z CD 0 CL V CO) C C CO2 W vI W W W vI W W CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MAS& SCALE 10-=Q DA7E5H2lll8 611 6-1i. i Scott L Gfes R.P.LS Frank & Gies 50 Deer MeedOw Road North Andover, Mases 00) „rCl0 , �01 I �G - cn� -I CERTIFY THAT OI*FSETS SHOWN ARE FOR THE USE"Q THE OFFSETS OF THE BUILDING INSPECTOR ONLY y� SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING DETERMNNATION OF ZONING BYLAWS OF NORTH ANDOVER - C©NFORMITY OR NON -CONFORMITY WHEN BUILT WHEN CONSTRUCTED. CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE:1 "=40' DATE:512/98 . Scott L Gi/es R.P.LS. Frank. S. Giles 50 Deer Meadow Road North Andover, Mass. ?'OP� Vol ?G IPA i 6P I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE BUILDING INSPECTOR ONLY �. _ ;.. g •.. � SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING $ :, DETERMINATION OF ZONING BYLAWS OF CONFORMITY OR NON -CONFORMITY ECiSiEa NORTH ANDOVER . �E IAm WHEN BUILT WHEN CONSTRUCTED. Office of —in erairs fi ifsines, de 'g, a o HOME IMPROVEMENT CONTRACTOR Registration: 41108383 Type: Expiration: $h1,8I012 DBA F K CONSTRUCT(01�FC Kenneth Keen 21 Hewitt Ave No. Andover, MA 018x5 Undersecretary -Ak Massachusetts - Department of Puhlic Safet% Board of Building Regulations and Standar(IS Constructpn Supervisor License License: CS 58245 Restricted to: 00 KENNETH B KEEN 21 HEWITT AVE N ANDOVER, MA 01845 ( �uiunisci,.utcr Expiration: 3/24/2012 . ITr#: 20523 Massachusetts - Depai-tinent of Public SafetN Board of Buildin- Re�-ulations and Standards Construction Supervisor License License: CS 76691 Restricted to: 00 ROBERT A KEEN 12 E WATER ST N ANDOVER, MA 01845 j Expiration: 8/16/2011 ( ,unntissiuncr Tr#: 1690 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): `L Z_ >. .01 0d M � ( , Address:_,g t 0a LU "V 6 ✓ 4 City/State/Zip:_0 , f }N A- 44, Dl t �`� Phone #: ? 7J -(n Q (• 070 Are you an employer? Check the appropriate box: I . Ly'I am a employer with t_ 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors �. E] I am a sole proprietor or partner- listed on the attached sheet. : ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t These sub -contractors have workers' comp. insurance. ❑ 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.] 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. ❑ Roof repairs 13. ❑ Other rmy appncam mat cnecxs oox IF t must also till 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. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. 11 Insurance Company Name: 6 2 T i9 u r S /I C Policy # or Self -ins. Lic. #: w C D D 7 It 0 a Expiration Date: S6 < < Job Site Address: q O s t 17 L E!-,- 12,;4q.,- 12--k City/State/Zip: P. R.4 Q!$ y s - 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. I do hereby certify under the�iAins and penalties of perjury that the information provided above is true and correct Phone #: L rz - k 9 I " Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # -,/�-H Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: 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 "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a 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 this affidavit may be 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 permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/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 bum 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 5-26-05 www.mass.gov/dia 5/23/2011 9:41 AM FROM: Gilbert Gilbert Insurance Agency, Inc; TO: +1 (978) 682-3231 PAGE: 001 OF 002' A DW. CERTIFICATE OF LIABILITY INSURANCE 05/2 /2011 PRODUCER (781)942-2225 FAX (781)942-2226 Gilbert Insurance Agency, Inc. 137 Main Street Reading, MA 01867-3922 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Kenneth Keen & Robert Keen DBA: DBA Keen Construction Company 21 Hewitt Ave. North Andover, MA 01845 INSURERA: NORFOLK & DEDHAM INSURANCE 23965 INSURERB:.Granite State Ins. Co. 0077 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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 SHOWN MAY HAVE BEEN REDUCED.BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICYNUMBER POLICYEFFECTIVE POLICYEXPIRAft— DATE TION LIMITS GENERAL LIABILITY NO—P-010078/000 03/13/2011 03/13/2012 EACH OCCURRENCE $ 1,000,00( X COMMERC14 GENERAL LIABILITY DAMAGE TO RENTED $ I(FA occurence) 5O, OO CLAIMS MADE Fx—] OCCUR MED {.XP (Any one person) $ 100,00( A PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2, 000, 00 —XI POLICY Pj� LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Par accident) GARAGE LIABILITY AUTO ONLY - FA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLALIABILITY EACH OCCURRENCE $ OCCUR F-1 CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC009646942 08/03/2010 08/03/2011 WCSTATII 0TH FR EMPLOYERS' LIABILITY WC. CERT TO BE MAILED B ANY PROPRIETORIPARTNEWEXECUTIVE E.L. EACH ACCIDENT $ 100 .000 OFFICERIMEMBEREXCLUDED? DI tECTLY VIA GRANITE INS E.L.DISFASE- FAEMPLOYE $ 100,00 It, yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS Evidence of Coverage SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 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, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Evidence of Coverage I AUTHORIZED REPRESENTATIVE lbert, CIC ACORD 25 (2001108) OACORD CORPORATION 1988 IN Lo Q --4 7(1 D t z U3 LO >n P.m z Z 0 r m UrNi m X zN N z 0 N_ N_ LD zm ��0 .mm 6rlL -Awo A 0U m rn z -+ N 0 (3) m N A� �z � m 0 z i A A Fn m (p N 0 E mU) Elm(Pr- �tNt -moi �D X G, x C p 0 (1 0 A O „- z z M -4m C� n � 3 E =i G� �8 m A B �zz0 n m np N _ g�6 o _� m o < z N O I II. A % O r m Z W Ui N S UJEN z o� EZ _�Zz 7�J zrn r0 4 mm Turn mmz u;uR CZ �0 A 1) X z 0_ 0 (`p X Vv ^ w N � a z X OA I 0 O /� O D A O TM L z m N WwQm�E �Oz�� n m z . z z70, i A N 2 N -0 VJO n Fp -� Z MT r� 66 4 Z�U' �o -;u r m rnrnz ';- rn rn O z m tV 0 KEEN CONSTRUCTION CO. GP a 21 HEWITT AVENUE NORTH ANDOVER. MA 01845 Tel: (978) 691-5201 Fax: (978) 682-3231 SubmittedTo v v.v v 1;J 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. EIN NO. �? S _ � 2,9- 0'715 �� q 1' MA. H.I.C. 108383 26-0462904 > C/S = Customer Supplied S + I = Supply + Install X See Attached Appendix A We hereby submit specifications and estimates for work to be performed and materials to be used ----___....._.....-_...----- --- ---- _ .... > Construction related permits: 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 t� 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 2of I A �, Two 11 611--rknal ,ii,a Il5v�l Payment to be ma4e as follows: % ($ ) upon signing Contract; ($ ) le�io of upon completion of ; Shall be made forthwith upon ($ ) completion of work under this contract. KENNETH B. KEEN / ROBERT A. KEEN Name of Contractor / Designated Registrant 21 HEWITT AVE. Street Address N. ANDOVER, MA 01845 - City r State (978) 691-5201 (978) 682-3231 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!,Salgsman 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 Authorfied-sioature / equipment, whichever amount is greater. C-' Note: 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, 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 / � A Date Signature Date IMPORTANT INFORMATION ON BACK 11111110- KEEN CONS-MUCT ON CO. GP 21 f(FWrr^r AVE. N. ANDOVER, MA 01845 978-691-5201 Kent, Jerry & Kellie 80 Settlers Ridge Rd. N. Andover, MA 01845 978.-289-0715 Contract # 5053; Appendix A Bate: 6/14/2011 Create Screen room: • Create working drawings as per conversations with customer o Remove & dispose of existing 10'x 16' deck e Create 16'x 18' screen room with 2" x 4" wail, 2" x 12" floor, 2" x 8" roof, ZIP sheathing on walls and roof a Supply & install FVC exterior trim, cedar clapboards to match existing • /architectural roofing to match existing e Interior walls to be covered with 1" x 6" v -groove knotty pine a Interior trim to be 1" x 4" knotty pine • Supply{ & install (3) 4!'x 6" fir beams for collar ties • Supply & install Harvey screen windows o Supply & install 6' vinyl sliding door with thereto pane glass o Paint exterior and urethane interior a flooring to be determined at a later date with a $5/sq, ft. allowance • Supply & install outlets to code, fansafe in ceiling and exterior Gl=l outlet & light wiring for fixture with switching to code ® Install customer supplied light fixtures Total Price: $32,000.00 (Thirty Two Thousand dollars) Price does not include cost of permits, changes required by inspectors or light fixtures, problems while digging, etc. ledge ,oversized boulders, or water. Page 1 of 2 KEEN CONSTRUCTION CO. CP 21 -MEWI r AVE. N. ANDOVER, MA 01845 978-691-5201 Xae*tCa*utru,-A-bynCoxonv- Payment Schedule: $5600.00 due upon signing contract I -t, 0 $5000.00 due when demo & excavation is complete (plus permit fees) $4000.00 due when deck is complete $4000.00 due when structure is framed $3000.00 due when roofing is complete $5000.00 doze when screens and siccing is installed $2500.00 due when pine is installed on walls and ceiling $2900.00 due when contracted work is complete customer Kenneth B. Keen Date Date Page 2 of 2