HomeMy WebLinkAboutBuilding Permit #497 - 90 WOODSTOCK STREET 1/8/2007Permit NO:
Date Issued:
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
--J,,- v
Date Received ` /
I IMPORTANT: Applicant must complete all items on this page
LOCATION QC7 CJS 04
Print
PROPERTY OWNER �u %%E�- . nt "
Print
MAP NO.:2/0/ct:,' PARCEL:
TVPF AND ITCF. nF RITILDING
ZONING DISTRICT:
HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ Addition
alteration
�
❑ Industrial
❑ Repair, replacement
❑ Demolition
Ch
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
❑ New Building
❑ Addition
alteration
❑ One family
❑ Two or more family
No. of units:
❑ Industrial
❑ Repair, replacement
❑ Demolition
❑ Assessory Bldg
❑ Commercial
❑ Moving (relocation)
❑ Other
❑ Others:
❑ Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
1?irndcl f 1 l�i fchzri (5iL
Identification Please Type or Print Clearly)
OWNER: Name: rU Phone.'?'72 - 29"V- 6 (o,
Address: 90 L O oLJ C -�o c I c S %U , 1
CONTRACTOR Name: A l i N Phone9'7F ' 6Q/ I Selo 1
Address: Z I m L' W I% 9 vg- U -
Supervisor's Construction License: Y4 Z 4J Exp. Date: 3 ` 7,'l - a i -
Home Improvement License: / O 1? -37 -S Exp. Date: 'F —19 -eq
ARCHITECT/ENGINEER Name: Phone:
Address: Reg. No
FEE SCHEDULE: BULDINC PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COS . BASED ON$12.00 PER S. F.
Total Project Cost :$ n _ -1 SZ FEE:$
i
Check No.: / 0� Receipt No.:�
Page 1 of 4
TYPE OF SEWERAGE DISPOSAL
Tanning/Massage/Body Art ❑
Swimming Pools ❑
Public Sewer
Well
Tobacco Sales Ll
Food Packaging/Sales 11❑
❑
LlPermanent Dumpster on Site
Private (septic tank, etc.
Electric Meter location to
project
NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fu
Signature of Agent/Owner Signature of contractor
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED
PLANNING & DEVELOPMENT ❑
COMMENTS
DATE REJECTED
CONSERVATION
COMMENTS
IN
DATE REJECTED
HEALTH ❑ ❑
t COMMENTS
DATE APPROVED
DATE APPROVED
DATE APPROVED
FIRE DEPARTMENT - Temp Dumpster on site yes t/ no
Fire Department signature/date„ r./ / — Fr
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
Building Setback (ft.)
Dimension
Front Yard
Side Yard
Rear Yard
Required
Provided
Required
Provides
Required
Provided-
rovided
Dimension
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
NOTES and DATA — For department use
Page 3 of 4
Doc: INSPECTIONAL SERVICES DEPARTM ENT: BPFORM05
Created .IMC. Jan.2006
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
Addition Or Decks
❑ Building Permit Application
❑ Surveyed Plot Plan
o Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
o 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)
o 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
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:BPFORM05
Page 4 of 4
Location9d O()Oows ne�
No. ? Date
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Check # [p�U
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19922
TOWN OF NORTH ANDOVER
Certificate of Occupancy $ ..r
Building/Frame Permit Fee $
Foundation Permit Fee $'
Other Permit Fee $
TOTAL $
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WECIO
The Commonwealth of Massachusetts
xl - 1g1>f De artment o Industrial Accidents
Office ofinuestigations
Washuz ton Street 7tl' Roof -
600
g
.Q; Boston Mass. 02111
Workers' Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors
Applicantmf'oi matron: PleasePRINT leabNy
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address: 2 J 6" ,e W ! /( / r L9
ritv JJ . A N /( /1 11 rA., ./2/7_-i . _ .Sr d_J r•1 .•� , - -^—
❑ I am a homeowner performing all work myself.
Project Type
New Construction BKemodel
I am a sole proprietor and have no one working in any capacity. El Building Addition
I am an employer providing workers' compensation .for my employees working on this job.
company name:
city:
phone #
LJ 1 am 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
ohc #
company name:,
city:
phone #•
Attach additional sheet rf nece`ssary 4.
w :....
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 underthe pains andyenalties of perjniy that the information provided above is trite and correct.
Signature Date f — c6 'Q
Print name cc TV, L
L0� 1Li £ { � (���? --Phone � 7 b ^.)
s s, x
hon # �� f
official use only do not write in this area to be completed by city or town official
city or town: permit/license #
r ❑Building Department
El check Board check if immediate response is required ❑Selectmen's Office
❑Health Department
contact person: phone #; ❑Other
(revised Sept. 2003),.'{
Proposal
Dracut Kitchcn & Bath
18 Chuck Drive
Dracut, Ma 01S 26
(978)453-3869
To: Mark & Susan Duller
90 Woodstock it.
N. Andover, M;t 01845
Re: Kitchen project
Specifications: As per layout provide i
Date: 12-19-06
Customer: Keen Const.
Phone:
Site: Same
Cabico (abinetry
Red Birch wood species (Natural Finish)
1/z" concealed framed coast7uction
Particletoard construction
Natural naple interiors
Full %" shelving
Solid nu ple dovetail dra, ver boxes
Blum tat idem Full extension glides
Slab E d -awer heads
Roman . %rch wall cabinet s
Square raised panel base,
351/4" high wall cabinets
Medium crown molding
Also mal thing 5/8" wood toe kick
Matching accessories as required for install
14" deer Wall cabinets
Light bat' molding
2 Roll-out t Vs
1 Super Susan cab
3 Angled will ends
Tilt out soap tray at sink bane
3 Angled Bi -se ends
Pricing include,; delivery to site. Storage charges apply to order that are
unable to be de.ivered
Cabinetry total:
$13,365.00
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KEEN CONSTRUCTION CO.
21 HEWITT AVE.
NORTH ANDOVER, MA 01845
(978) 691-5.201
Fuller, 'Susan & Mark
90 Woodstock St..
N. Andover, MA 01845
(978):794-9 16.6
Contract# 1651; Appendix A Date: 1/2/07
Remodel Kitchen:
• Remove existing cabinets
Close. in opening between kitchen and living room to accommodate new cabinet layout
• Remove plaster on two exterior walls
• Remove existingtile: on floor
Supply & install.R-13 insulation. on exterior walls
• Supply & install blueboard on exterior walls, ceiling and other patches as necessary,
skimcoat plaster to smooth.finish
• Supply & install hardwood floor ($1100.00 material allowance)
Install customer, supplied cabinets from Dracut Kitchen & Bath dated 12/19/06
• Install. customer supplied tile backsplash (labor only,. standard installation)
• Supply & install trim on door openings, windows and base to match existing
• Dispose of all debris
• Install. five 6 -panel pine door blanks
Electrical:
• Update electrical outlets to code
• Supply & install twelve recessed lighting fixtures and. necessary switching
• Supply & install one phone outlet and one cable outlet
• Electrical allowance $2800.00
Plumbing:
Reconfigure kitchen sink vent
• Remove existing baseboard heat in dining area and install one toekick heater,
• Install customer supplied sink, faucet; dishwasher and water supply for refrigerator
• Plumbing allowance $2700.00
A
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
} - Registr4llgO� 108383
_ ExpRatlsi�a X118/2008
TYPe ,BA
-' K€EWCONSTRUCM40Q
Kenneth Keen
21 Flewitt Ave ti i
No Andover, MA V845'Deputy Administrator
{�arnirrcancrtea��
BOARD OP BUILDING REGULATIONS
t
ieens.; CONSTRUCTION SUPERVISOR
Number SCS 058245
?y
JN' :8ate 03/2`4/4943
Tr.
no 1:3436•.
F ,=RbS.,iciedx
Y
i EN3�
21 HEWITTA�
i
KEEN CONSTRUCTION CO.
n� 21 HEWITT AVENUE
NORTH ANDOVER. MA,01845
Tel: (978) 691-5201
Fax: (978) 682-3231
Submitted C G t'� 1 � n _r:. =_.....___FL_j.L�4
To: ............._............................................._.....
GOao�!!
I..-.._ ..... ...._.�...�......... ... _...-��!
�. 1651
1Ss
PROPOSAL
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. L D. N0.
-7,9q — 91 -07 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:
M
Construction related permits:
e e H�PCnd,.
.n
__..._......_................................................
......................................
............................•......,.................................................,.......................................................
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 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 r, 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
SI I -e dv_ cod M y HundA FiahtV(d 5X,0 9' 7, 5
Payment to be made as follows:
dollars ($ �� t )
_ % ($ ) upon signing Contract;
KENNETH B. KEEN
Name of Contractor / Designated Registrant
($ ) un Eple
tjj 21 HEWITT AVE.
Street Address
�$l _) u, otion of — N. ANDOVER, ANDOVER, MA 01845
City / 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 Name of s lesma r
or the total amount of all deposits or payments which the contractor must make, --
advance, to order and/or otherwise obtain delivery of special order materials and AuthQrLMd Sibnature ,
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 SIGN THIS CONTRACT IF THERE ARE AY B N PACES.
I -
Signature - . l
Date Signature Date
IMPORTANT INFORMATION ON BACK ►