Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 105 HICKORY HILL ROAD 4/30/2018
Location No. Date i TOWN OF NORTH ANDOVER e ; : Certificate of Occupancy $ '7b''•°''c�' Building/Frame /Frame Permit Fee $ �ss.�....sa 9 Foundation Permit Fee Other Permit Fee TOTAL Check #� r $ - Building Inspects c, TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 77 BUILDING PERMIT NUMBER: 113 DATE ISSUED• SIGNATURE: ItIl /l/t Building Commissioner/1for of uildin Date SECTION 1- SITE INFORMATION 1.1 Property Address: SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 1.2 Assessors Map and Parcel Number: 2.1 Owner of Record /O,S #7 C kOrn/ /�c� 2 �4 ?7,q -?7Q - Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone `+ W% ,nber Parcel Number SECTION 3 - CONSTRUCTION SERVICES 371 Licensed Construction Supervisor: Not Applicable ❑ Liv ensed Construction Supervisor: 1.3 Zoning Information: - 1.4 Property Dimensions: License Number ?� Address �- ,q - 2-70- 2 ?-Ar Signature Telephone Q 2'7,r7-79 /DD Zoning District Proposed Use Lot�Area (sf) Frontage ft Il 2 Z 1.6 BUILDING SETBACKS ft Z G )"Ccy .S/ `2.�LL ' Front Yard 4:S-�-n�atu, Side Yard ?-8 --Zoo/ Rear Yard Required Provide Required Provided Required Provided 1 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public X Private - ❑ Zone Outside Flood Zone. Municipal ,3e- On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record bQ li/d 9 .� �at-a �] 7 -})run /l1.S htrckUr>r 11�// Wil. Name (Print) Address for Service : ?7,q -?7Q - Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 371 Licensed Construction Supervisor: Not Applicable ❑ Liv ensed Construction Supervisor: 000Z-7 / ZI? /,Al�Q il2 e J76- 7` License Number Address �- ,q - 2-70- 2 ?-Ar Signature Telephone Q Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ `9 JA/4 Il 2 Z Company Name Z G )"Ccy .S/ `2.�LL ' Registration Number 4:S-�-n�atu, Address ?-8 --Zoo/ Expiration Date Tele hone SECTION 4 - WORKERS COMPENSATION (NVLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildina 22rmit. Si ned affidavit Attached Yes ..... No.......❑ SECTION 5 Description oiProposed Work(check alla Ucable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition " Accessory Bldg. ❑ Demolition ❑ Other -'-0 Specify Brief Description of Proposed Work: J r CQQ,r �`%JC LL % Z I •� / �r/M i he/ rau n 0'-1 AOO f-'ri\f `oi d ecke SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be ant Completed by permit a lic;L QFICIAL USE'�NLY 1. Building/'7t �� (a) Building Permit Fee Multiplier 2 Electrical 000 (b) Estimated Total Cost of Construction 3 Plumbing 000— Building Permit fee (a) X (b) 4 Mechanical HVAC — 5 Fire Protection 6 Total 1+2+3+4+5 m Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION as Owner/Authorized Agent of subject prope y Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief 20��•vr- Print NN�am))e__�yt Si satire of Owner/A ent Date G NO. OF STORIES SIZE k BASEMENT OR SLAB y/ SIZE OF FLOOR TIMBERS 2 3 RD— SPAN /2-1 DIN ENSIONS OF SILLS AITT DIMENSIONS OF POSTS & X D-IWNSIONS OF GIRDERS HEIGHT OF FOUNDATION /V THICKNESS SIZE OF FOOTING 12 " �� `( X MATERIAL OF CHMINEY IS BUILDING ON SOLID OR FILLED LAND 'Fau10 IS BUILDING CONNECTED TO NATURAL GAS LINE e-4 I I 4 °:'"'° '• ."° TOWN OF NORTH ANDOVER PERMIT FOR WIRING 'r This certifies thatti- •--1 .% ..-~ .................................... ......................................................... has permission to perform ..............:................................. wiring in the building of . `......................................................... at!_.!, �.:.............. . North Andover, Mass. Fee.. l ............ Lic. No. f /;? { l!... ........................... / ELECTRICAL INSPECTOR Check # 47 9 7;?15 eM=M6XZ7W 6157 ao�x 4 p-&& S4 0 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 O-ffici al Use Only Permit No. /. 7fip Occupancy & Fee Checkedi APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described/70w. j Location (Street &Number /, /7 / Ch®� �'1 � Owner or Tenant L V Owner's Address Is this permit in conjunction with a building permit Purpose of Building Existing Yes Vr No ❑ (Check Appropriate Box) G Z -0 2, d Voits Overhead ❑ New Service Amps Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Overhead ❑ F `AI'5h 'If6t566 Authorization No. Undgmd IFr__ No. of Meters _ ( Undgmd ❑ No. of Meters OTHER: JNSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = if u I)a ch ed YES please indicate the type of coverage b checking the appropriate box IN SU BOND = OTHER = (Please Specify) (1 (9 (Expiration Date Estimated Value of Electrical Works Work to Start Inspection Date Resquested Rough FinalSigned Q 7 FIRM NAME under the Pen ies of pe /( LIC. NO. Lfensee ipi Signature 2 LIC.NO. Address uW C 54/ h Bus Tel. s. Tel No. �' G is — e- 7 OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMITfEE (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ 7No. of Lighting Fixtures i Swimming Pool grnd ❑ grnd ❑ Generators KVA 'Z_ No. of Emergency Lighting No. of Receptacles Outlets Z No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Di sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring No. Hydro Massage Tuds No. of Motors Total HP OTHER: JNSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = if u I)a ch ed YES please indicate the type of coverage b checking the appropriate box IN SU BOND = OTHER = (Please Specify) (1 (9 (Expiration Date Estimated Value of Electrical Works Work to Start Inspection Date Resquested Rough FinalSigned Q 7 FIRM NAME under the Pen ies of pe /( LIC. NO. Lfensee ipi Signature 2 LIC.NO. Address uW C 54/ h Bus Tel. s. Tel No. �' G is — e- 7 OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMITfEE (Signature of Owner or Agent) Name Name: Location: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print City Phone # I am a homeowner performing all work myself. 0 I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job Companv name: Address City: Phone #: Insurance. Co. Poligy# Company name: Address • C;,)c Phone# Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the irnpositim of criminal penallies up to $1,500.00 and/or one rears' w pmorxnent� weU-as_c bM-penaltieslnsheiorm�f_a.STQPYYOMOM).ERand_afioe_d� _a,dayeagainstme 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for overage verification. I do hereby certdy under the pains and pemiGes ofperjury that the information provided above is true and correct. Signature Print name Phone.# Official use only do not write in this area to be completed by city or town official' City or Town Perrnit/l:icensing Building Dept []Check if immediate response ,is reguired Licensing Board E] Selectman's Office Contact person: Phone # E] Health Department Ei Other 4 Date ......11�Iizrl- ................ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION t �9SSACMUSE� This certifies that -�- has permission for gas installation; . �� ,i ............ in the buildings sof./(.f�.1.J,,,,,,,,,,,,,,, at AJr.a(t ..1 f�, North Andover, Mass. Fe �-�' L' X .' Fee. ... ic. No.. �.3� ... .......................... GAS INSPECTOR Check # 6 T 4838 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING %Print or Type) .Mass. Dat zz Z_ unit --RBuilding tion 4A(/4f&LersNam f t /�6-1 le Z�2� AW I Type of Occupancy__2 I� E5i i'-') N Ti r - New ❑ Renovation ❑ 1 eplacement 2 Plans Submitted: Yes❑ No ❑ Installing Company Name 'A r') fe a T A . �51m Al A T A r20 Check one: Certificate Address 30 CODA C H m A. ry i -NI . ❑ Corporation M = T H U e tJ 01 rl D ❑ Partnership Business Telephone 1,o -7 1 2-Firm/Co. Name of Licensed Plumber or Gas l=itter � r) jBE P T A - 5 A M ri'114-TA P -) -- INSURANCE COVERAGE: 'gave ayes errt }abiiiry insou a ce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked Yes, please indicate the type coverage by checking the appropriate box A liability insurance policy 00"00' , Other type of indemnify ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Owner[] Agent ❑ Signature of Owner or Owner's Agent 1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the pe i ed for this application ' be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 ofr4neLaws.T of License: Plumber f cen u _ or Gas Fitter TrUe tter er License Number V3-2) �tyRown O IC Journeyman Y NEEMEMENEENOMENES SOMEONE • • .■. ■■■■■■�.�■■■�■■■■■�. On. Installing Company Name 'A r') fe a T A . �51m Al A T A r20 Check one: Certificate Address 30 CODA C H m A. ry i -NI . ❑ Corporation M = T H U e tJ 01 rl D ❑ Partnership Business Telephone 1,o -7 1 2-Firm/Co. Name of Licensed Plumber or Gas l=itter � r) jBE P T A - 5 A M ri'114-TA P -) -- INSURANCE COVERAGE: 'gave ayes errt }abiiiry insou a ce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked Yes, please indicate the type coverage by checking the appropriate box A liability insurance policy 00"00' , Other type of indemnify ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Owner[] Agent ❑ Signature of Owner or Owner's Agent 1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the pe i ed for this application ' be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 ofr4neLaws.T of License: Plumber f cen u _ or Gas Fitter TrUe tter er License Number V3-2) �tyRown O IC Journeyman 2 I 1- W r N J � Z O O W � W V1 O H H ~ W Z V � W < �y O O z d ic O816 O F o G Q 3 = a c J F. W � m V J d d < W W Y. I r W H Z < �y � F o G Q F. us o - � c O Q ' W m C = dJ MORTGAGE INSPECT/ON PLAN Ar 105 HICKORY HILL ROAD NORTH ANDOVER, MA. ND. ESSEX REGISTRY OF DEEDS.' BK. 3744 PG. 323 11 H to PLAN NO. Il,9Il CERTIFIED T0: WASHINGTON MUTUAL BANK, FA SCAL E: /"v 40' DATE.' JANUARY 22, 1998 25118 % ACCESS/EGRESS I 0 8 UTIL/TIES EAS'M. 150.00 0 ?`.Wo .. � SURVEYORS C042WER CHANDLER g0AD, ANDOVER, MA. aAl=xs; N��EcK wa \ LOT 6'7- k zo 2 STORY r O 27,778 SE i WQFRM. t 3 0.59 NOTES.' I) THIS /S NOT A PROPER Y SURVEY, DO NOT USE THIS PLAN TO ESTABLISH PROPERTY LIMES OR to ERECT ANY STRUCTURE. 2) PROPERT Y LINES ARE DETEPmINEO FROM COMPILED INFORMATION TO BE USED FOR MORTGAGE PURPOSES ONLY. CERTIFICATIONS.* BASED ON MY KNOWLEDGE, INFORMATION AND BELIEF l HEREBY CERTIFY THAT THE PERMANENT STRUCTURES IND/CATED ARE LOCATED ON THE GROUND APPROXIMATELY AS SHOWN AND ARE CONFORMING TO THE ZONING SETBACK REOUIREMENTS OF THE APPL ICABL E MUN/C/PAL/TY WHEN CONSTRUCTED OR MAY BE EXEMPT PER MASSACHUSETTS GENERAL LAW CHAPTER 40A, SECTION 7, AND THAT THE STRUCTURE SHOWN ISNOT LOCATED /N A FL 00D HAZARD ZONE PERFEDERAL EAERGFNCYM44M4GEl9NTAZWYM,4P.' COMMUNIT Y NO.250098 EFFECTIVE DATE.' 06- 02-S5 ZOYVE.'X JOHN ABAGIS° 41 ASSOCIATES, PROFESSIONAL LAND SURVEYORS 137 CHANDLER g0AD, ANDOVER, MA. (508) 688-4899 w Iry w. w ♦ 1 r • •ri &epi &AA IYrrG. /V /Y I Y 1 . / f lrT w"Vl . u^ -2-AP•s-9 /rV. JWJ/ FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all -necessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. ............................................................................ APPLICANT 'Z� e: 4- A 1, a Rfrr PHONE 971 97d - ,?Z/s- ASSESSORS MAP NUMBER LOT NUMBER 1 l 0 SUBDIVISION/LOT NUMBER 4 STREET #-k 1Lyr)/ t -A'11 STREET NUMBER /O.S ................ ......................................................Esse. OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS m DATE APPROVED Z' n �Q ICONS VATION AbMRMTRATOR �) `�-(' _ I ] DATE REJECTED COMMENTSU'6 V 't Uj e f "" Ul) W/ �' (w, DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR - HEALTH COMMENTS---- PUBLIC OMMEN S PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT COMMENTS RECEIVED BY BUILDING INSPECTOR DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED 4� 67 BOARD OF*BUI'-bf4GRtGULA`i6- 9 T N �icense: CONSTRUCTION SUPERV&R Number CS 048,827 Birfhdlate.- 08/28/1463 ' Expires --- ;-08/28/2001. Tr. 46: 4185 Qo 13013ERT A LAFLt 123I -A FAYETTE St IOWELL, MA 01854 Aciminist(06t HOME TMPROVEMENf CONTRACTOR Reoistrarion 1 1,1?32 Type WTV [DU,41, Ex.piratJOR 12128101 ROBERT A'LAFt.EOR ROBERT A. LAFLEUR, !� I.AFOETTE ST ADMINISTRATOR LOWFUMA 01854 Town of North Andoveroti t►ORTH Building Department o 27 Charles Street North Andover Massachusetts 01845 Z (978) 688-9545 Fax (978) 688-9542 09 `°"" �• �` SACHUs���y DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 50a. The debris will be disposed of in /at: Facility location Signature of Applicant Date Z -J--00 NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: "Aer-t l rt rlt;vl- Location: / ZsS� kQ fate t�ift_ Ste' City 40 L4/lell/ M Phone —( am a homeowner performing all work myself. am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job Company name: Address City Phone #: Insurance Co. Policy.* Company name: _ Address City Phone* - Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 andtor 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. ! do herby certify under the pains and penalties of perjury that the information provided above is true and correct Signatur Print name /tel'" C— f 1� ' ca /�/ �-vr Phone # 5'79 - ?70--2 2,/,) - Off icial a,)1Ofhcial use only do not write in this area to be completed by city or town official' E Building Dept ❑Check if immediate response is required Building Dept E] Licensing Board F1 Selectman's Office Contact person:_ Phone #: 0 Health Department Other FORM WORKMAN'S COMPENSATION Professional Building & Remodeling, On time, On Budget, or We'll Pay You, Guaranteed in Writing AGREEMENT FOR SERVICES This Agreement, along with the attached plans and specifications (if applicable), is the entire Agreement, and replaces any prior agreements. Date of this AEreement: November 28, 2000 Description of work to he completed: Addition See attatched specifications Name of Salesperson: Robert A. LaFleur Limitations on work to be completed: Any items of work or services not specifically provided for in this Agreement are excluded. This excludes, but is not limited to, any unspecified alterations to existing structures or disposal of unrelated existing materials on site. Client name and address: Mr. & Mrs. David Thrun, 105 Hickory Hill Rd., No. Andover, MA 01845 Job Location: Same Price of specified work to be completed: $30,256.00 Payment Terms: $2,000.00 due upon execution of Agreement for Services, then equal payments of $5,400.00 beginning on start date and continuing thereafter for a total of 5 weeks. Balance of $1,256.00 due upon completion. Completion: Work shall be deemed complete when all stated services have been initially completed. It is understood that routine "punch -list" and repair items are beyond the scope of completion and are covered under builders' warranty obligations. Builder is not responsible for delays incurred due to the actions or inactions of city/town officials, strikes, Acts of God, unfulfilled customer obligations or other delays beyond our control with regard to this agreement. Work to begin on or about January 15, 2001 and be completed within 5 weeks. Building Professionals will incur a penalty of $100.00 /business day beyond completion date. A 48 hour notice will be given prior to actual contract start date. Additional work: Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the amount specified above. Insurance: Owner to carry fire, tornado, and other necessary insurance upon above work. Public Liability Insurance and Workmen's Compensation Insurance on above work to be taken out by Building Professionals. Notice: All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration, One Ashburton Place, Room 1301, Boston, MA 02108, Tel. (617) 727-8598. Your cancellation rights: Subject to the provisions of MGL c.93, s.48; MGL c. 140D, s.10 or MGL c.255D s.14, as may be applicable, the owner may cancel this contract within three business days of the date the contract was signed. Warranty: Building Professionals warrants its work and the product(s) used therein against defects in materials and workmanship for a period of one year from the date on the Invoice for final payment. During the warranty period, Building Professionals will, at its option, either repair or replace products or workmanship which prove to be defective. This warranty shall not apply to defects or damage resulting from improper or inadequate maintenance by the customer, customer supplied products, unauthorized modification or misuse, damage incurred as a result of Acts of God or Civil Strife. The warranty set forth above is exclusive and no other warranty, whether written or oral, is expressed or implied. Building Professionals specifically disclaims the implied warranties or merchantability and fitness for a particular purpose. Owner's Rights: You are dealing with a registered Home Improvement Contractor and are entitled to certain rights MCLS # 048827 HICR # 117932 FEIN # 04-3407556 123 LAFAYETTE ST. LOWELL, MA 01854 978-970-3215 under the,provisions of 780 CMR R6 and MGL c. 142A. 'Liens: There are NO liens or security interests on the residence listed above as a consequence of this contract Final Payment: If final payment is not received within 30 days of completion, the owner shall be responsible for all court costs and other costs incurred by the contractor, in attempting to collect final payment. Permits: All necessary construction -related permits will be obtained by the contractor or its subcontractors. Any owner who secures a construction -related permit on their own, shall be excluded from access to the Guaranty Fund. Unregistered contractors: Any owner who deals with an unregistered contractor will be excluded from access to the Guaranty Fund. Building Officials: Any additional costs incurred by the contractor as a result of decisions made by building officials will be the responsibility of the .homeowner. The cost of the additional work will be calculated as follows: Material cost plus an hourly rate of $30.00/man hr., plus a reasonable mark-up for profit and overhead. Arbitration: The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract, the contractor may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as providedAn MGL c.142A. 6 Contractor, Robert A. LaFleur Date NOTICE: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties. All work to be completed in a good and workmanlike manner. All changes shall be indicated on this Agreement, plans and specifications (if applicable) and initialed by both parties. The above prices, specifications and conditions are satisfactory and are hereby accepted by all parties. Building Professionals is authorized to perform 14e work as specified. Payment will be made as outlined above. izlYla� Owners Name(s) Contractor, Robert A. LaFleur Date Building Professionals 123 Lafayette St. Lowell, 01854 NAME/ADDRESS Mr. & Mrs. David Thrun 105 Hickory Hill Rd. No. Andover, MA 01845 Proposal - Specifications DATE Proposal # 11/10/2000 2000070 PROJECT Addition DESCRIPTION QTY UOM LAB/MAT/0TH Building Permit 1 EA OTH 15 YD. dumpster 1 EA OTHER Dig out by hand to a depth of 4'-0", install 12" diameter sonotube, 5 EA LAB pour concrete, and backfill. 12" x 4' sonotube, ready mix concrete, anchor bolts, and post 5 EA MAT anchors for pier footings. Install 6x6 wood suppport posts. 5 EA LAB 6x6 pressure treated support post. 5 EA MAT Install galvanized post anchor base on concrete footing. 5 EA LAB 6x6 galvanized post anchor base including hardware. 5 EA MAT A CREDIT OF $92.69 WILL BE GIVEN FOR EACH FOOTING/POST NOT REQUIRED. AN ADDITIONAL CREDIT OF $20.00 WILL BE GIVEN FOR EACH FOOTING THAT THE BUILDING INSPECTOR DOES NOT REQUIRE TO BE EXPOSED FOR INSPECTION Install triple 2x8 built up wood beam. 34 LF LAB Triple 2x8 kd spf #2 & btr. wood beam. 34 LF MAT Tear out exterior beveled clapboard siding (cedar, hardboard, etc.) 204 SF LAB Install 2x6 kd spf sleeper joists 16" o.c. over existing deck. 252 SF LAB 2x6 kd spf sleeper joists 16" o.c. over existing deck. 252 SF MAT Install 3/4" t&g subfloor. (INCLUDING ENCLOSURE) 512 SF LAB 3/4" fir t&g plywood subfloor, including fasteners and glue. 256 SF MAT 1/2" cdx fir plywood 4x8 sheathing including fasteners. 256 SF MAT Construct bearing wood stud wall consisting of 2x6 kd spf studs 444 SF LAB 16" o.c., double top plates, single sole plate, door/window headers per code. Bearing wood stud wall consisting of 2x6 kd spf studs 16" o.c., 444 SF MAT double top plates, single sole plate, door/window headers per code. Install 1/2" 4x8 wall sheathing. 490 SF LAB 1/2" cdx fir plywood 4x8 sheathing including fasteners. 512 SF MAT Strip 1 layer of asphalt or fiberglass roof shingles and load into 174 SF LAB dumpster. 1 - 8 pitch. TOTAL Page 1 s . ' Building Professionals 123 Lafayette St. Lowell, 01854 NAME/ADDRESS I Mr. & Mrs. David Thrun 105 Hickory Hill Rd. No. Andover, MA 01845 Proposal - Specifications DATE Proposal # 11/10/2000 2000070 PROJECT Page 2 '4� ;Z PROJECT Addition DESCRIPTION QTY UOM LAB/MAT/0TH Install 2x10 shed roof rafters 16" o.c., with 2x12 ledger board. 371 SF LAB 2x10 shed roof rafters 16" o.c., with 2x12 ledger board. 371 SF MAT Install roof sheathing. 371 SF LAB 1/2" cdx fir roof plywood 384 SF MAT Install #2 primed pine fascia/rake/frieze board up to 1x12 52 LF LAB #2 primed pine fascia/rake/frieze board up to lx12 52 LF MAT Install fascia/rake trim moulding (flat/crown/bed) 52 LF LAB Fascia/Rake trim (crown/bed/flat) moulding up to 2 1/2" width 52 LF MAT Install #2 pine soffit up to 12" wide. 36 LF LAB #2 pine soffit up to 12" wide 36 LF MAT Install 2" wide white or MF continuous soffit vent. 36 LF LAB 2" wide white or MF continuous soffit vent. 40 LF MAT Install 36" wide ice & water shield along first Y of eaves and in all 38 LFT LAB valleys. 36" Ice & water shield. 38 LFT MAT Install 25 year 250 Ib. architectural fiberglass roof shingles and 8" 468 SF LAB galvanized metal drip edge along rakes and eaves. 4-7 pitch 25 yr. 250 lb.architectural fiberglass roof shingles, 8" galvanized 500 SF MAT drip edge and roof nails. Install rolled aluminum flashing up to 12". 8 LF LAB Aluminum flashing up to 12" g LF MAT Install double hung single window (wood, aluminum, or vinyl) 3 EA LAB Double hung window allowance $300.00 2 EA MAT Install picture window (wood, aluminum, or vinyl) 1 EA LAB Transom window. Allowance = $225.00 1 EA MAT Install bow/bay window. 1 EA LAB Bow/BAYwindow allowance $$1,500.00 1 EA MAT Install wood framed bay/bow window roof 1 EA LAB Bay/Bow wood framed roof 1 EA MAT Install pine exterior 908 or flat casing for window up to 6/0 width.. 4.5 EA LAB Pine exterior 908 or flat casing for window up to 6/0 width.. 4.5 EA MAT Install 1/2" x 6" beveled siding. 502 SF LAB 1/2 x 6 red cedar clapboard siding, nails, paper, etc. 502 SF MAT TOTAL Page 2 '4� ;Z Building Professionals 123 Lafayette St. Lowell, 01854 NAME/ADDRESS Mr. & Mrs. David Thrun 105 Hickory Hill Rd. No. Andover, MA 01845 Proposal - Specifications DATE Proposal # 11/10/2000 2000070 PROJECT Page 3 PROJECT Addition DESCRIPTION QTY UOM LAB/MAT/0TH Install cable jack 1 EA SUB Install phone jack. 2 EA SUB Install 6" recessed can fixture with black baffle eyeball and white 4 EA SUB trim. Includes dimmer or toggle switch(es) Install/relocate duplex receptacles per code, white or ivory. 9 EA SUB Install copper fin -tube baseboard heat on existing system. 20 LF SUB Install r19 kraft faced insulation 676 SF LAB R19 x 15 kraft faced fiberglass insulation 676 SF MAT Install R30 kraft faced insulation. 273 SF LAB R30 x 15 kraft faced insulation 273 SF MAT Install 1/2" blueboard 881 SF LAB/MAT Install skim coat plaster finish over blueboard 881 SF LAB/MAT Remove existing window, tear -out remaining wall under window 1 EA LAB/MAT and make new cased opening with jambs and 2 sides of casing. Install 1/2" pine clamshell, ranch or colonial baseboard. 44 LF LAB 3 1/2" pine clamshell, ranch or colonial baseboard. 44 LF MAT Trim existing window with 2 1/2" casing, apron, stool cap, and 5 EA LAB extension jambs as needed. 2 1/2" casing, stool, apron, and ext. jamb for existing window 5 EA MAT Paint smooth interior walls with roller using 15 yr. latex eggshell 608 SF LAB/MAT or satin finish. Primed + two coats Paint smooth ceiling with roller. Prime (1 coat) and paint (2 coats). 273 SF LAB/MAT 15 yr interior latex flat white. Stain (I coat) and polyurethane (2 coats) cased opening up to 6/0 1 EA LAB/MAT wide including jambs and 2 -sides of trim. Stain (I coat) and polyurethane (2 coats) baseboard, ceiling 44 LF LAB/MAT moulding, or chairrail up to 6" width. Stain (1 coat) and polyurethane ( 2 coats) one side only, of window 4 EA LAB/MAT up to 3/0 width, including all trim. Stain (1 coat) and polyurethane ( 2 coats) one side only, of window 1 EA LAB/MAT up to 7/0 width, including all trim. Install wall to wall carpeting including pad and tack strip at 27 SY SUB $20.00/sq. yd. TOTAL Page 3 Building Professionals 123 Lafayette St. Lowell, 01854 NAME/ADDRESS Mr. & Mrs. David Thrun 105 Hickory Hill Rd. No. Andover, MA 01845 Proposal - Specifications DATE Proposal # 11/10/2000 2000070 Page 4 'az�; PROJECT Addition DESCRIPTION QTY UOM LAB/MAT/OTH TOTAL $30,2s6.o1 Page 4 'az�; IN mmmm NEON no OMEN mill N��� c� 0 0 3 a� z w 0 N O N 00 N O N r U U OC J 0 b N .Nr N 00 N O N r U U OC J b .Nr C bA y O W CA N N N W 2 Cd 7-w O r -O `-1-r �i U N 'C3 bA o N @ % 00 7 ® S .§ k �/( )) \ ��§ ƒ� . C4 4 �« , a§ \\\ MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.0 CITY: Middleton STATE: Massachusetts HDD: 6063 CONSTRUCTION TYPE: 1 HEATING SYSTEM TYPE: DATE: 12-6-2000 DATE OF PLANS: TITLE: COMPLIANCE: PASSES Required UA = 90 Your Home = 79 or 2 family, detached Other (Non -Electric Resistance) Permit # Checked by/Date Area or Insul Sheath Glazing/Door Perimeter R -Value R -Value U -Value UA CEILINGS 280 30.0 0.0 10 WALLS: Wood Frame, 16" O.C. 424 21.0 3.0 22 WALLS: Wood Frame, 16" O.C. 96 13.0 3.0 7 GLAZING: Windows or Doors 65 0.320 21 GLAZING: Windows or Doors 6 0.290 2 GLAZING: Windows or Doors 20 0.280 6 FLOORS: Over Outside Air 240 21.0 11 COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. Builder/Designer- dDate MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 DATE: 12-6-2000 Bldg. Dept. Use CEILINGS: [ ] 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C., R-21 + R-3 Comments/Location [ ] 2. Wood Frame, 16" O.C., R-13 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U -value: 0.32 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location [ ] 2. U -value: 0.29 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location [ ] 3. U -value: 0.28 For windows without labeled U -values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location FLOORS: [ ] 1. Over Outside Air, R-21 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air -tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm -in -winter side of all non -vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R -values and glazing U -values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: All ducts must be sealed with mastic and fibrous backing tape. Pressure -sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. MISC REQUIREMENTS: Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------- 4 g CERT/F/ED FOUNDATION PLAN �. ' LOCATED /N o> - SCALE.' /= 4o DATE 43 t ,ScottL:-Gi/es RL.S. �`• r 50 Deer Meadow Rood 13972 S LA%rJ ZIg3 North Andover, Mass. x i v° '^ 41 / p ti TW7 ZIP d� t• _ aR r LIC,r lJ .. "Al,'': APR .2 1993 l CERT/FY THAT OFFSETS SHOWN ARE FOR THE USE ' THE'OFSETS . OF THE BUILDING /NSPEC TOR ONLY SHOWN COMPLY, AND SUCH USE /S FOR THE- o� W /TH;THEZON/NG DETERMINATION OF ZONING ' BYILALY' OF CONFORMITY OR NON- CONFORM/TY WHEN CONSTRUCTED. `WHEN.SU/L'r , $ � t 4-I 13972 S LA%rJ ZIg3 rA cz P� x w A "7 O w v cn p u z z p w O w v C U Cp uz O C7 w C w a w Uw w C o U w a z G uz w ca d a W w _ as z � O V) uj z H I co i. CD C O CD w CL y O .Q CO) O V Lli 0 Cn Lij Cn Irw w crw c w- o as c o VO V d� ac ca co 16; a O m Z' Ea :.m c CD «. CD a N Eclftovb CD /! V O O C� O, m G CIO : ; N 3 •J N L.. G3 N V x' Ca Rcc •� N Cc O El O, m o 0 N m m :E w o212 Q! c a_ �► V Z co O �oao c Q m� m c o 2 m a�0 N ~ w N D ~ m wO+ cc W E Z O V m 0.0 0 C H d O � O L H •O C _ H I co i. CD C O CD w CL y O .Q CO) O V Lli 0 Cn Lij Cn Irw w crw Locq,tion No. r n Date TOWN OF NORTH ANDOVER t,jt,uttTd-6COccupancy $ t- J(666 Ott — Permit Fee $ Foundation Permit Fee $ Other Permit Fee J $ft$ewer�oh@teTlion Fee $ Np%ater Connection Fee $ TOTAL $ 7 ! Building Inspector Div. Public Works Location No. �.� , Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ BuildinFsame Permit Fee ZTermit Fee awl I f 9 ,%OPA'-"'blher Permit Fee Sewer Connection Fee 6- -c Water CpsWtion Fee $ //,/-o pR TOT L ll $ =J/' � r • u '� Buildingrin/spector .] / r Div:'Pu6llc Works VZR]KIT�, No. �.� APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. ,f,id 3 .;t— J//PAGE 1 MAP d40. LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK 'PAGE ZONE �„ SUB DIV. LOT NO Sja liaY1lq1-1 LOCATION flj © PURPOSE OF BUILDING OWNER'S NAMEo �y1, OWNER'S ADDRESS O 1 ;eliqg I I VNO V O / NO. OF STORIES �7 SIZE _ x.3}L O BASEMENT OR SLAB �I�Q Ll• �� D ARCHITECT'S NAME 1_ p'll', V SIZEOF FLOOR TIMBERS ISSTT?,k I/l 2ND jyl� O RDBUILDER'S NAME 1k6*w b, �wko SPAN ) � DISTANCE TO NEAREST BUILDING'{.. / /� / i — DIMENSIONS OF SILLS �_T�11 --- DISTANCE FROM STREET z Zlt- " POSTS 3!/z SIc, L,h LLY DISTANCE FROM LOT LINES - SIDES / REAR jS ,� T " GIRDERS '7 y •1 FRONTAGE �V AREA OF LOT 7� p i' O HEIGHT OF FOUNDATION Re THICKNESS IS BUILDING NEW v� r SIZE OF FOOTING 7, X N IS BUILDING ADDITION/ 1J Q ✓�A-)b MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODEp ✓ IS BUILDING CONNECTED TO TOWN WATER �� BOARD OF APPEALS ACTION. IF ANY A 1 ,Q, VV v� IS S BUILDING CONNECTED TO TOWN SEWER �/ IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 1. SEE 80TH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS I - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING � DATE FILED �� / f SIUNATURE OF OWNEWdR AUTHORIZED AGENT FEE **'7170i S0 PERMIT GRANTED 4,41. Y19 dole x'96/ OWNER TEL. # 6� CONTR. TEL. #A� CONTR. LIC. #� 3 PROPERTY INFORMATION LAND COST 00 0 EST. BLDG. COST 'EST. BLDG. COST ' EST. o� EST. BLDG. COST PER SQ. OOFT. (16-00 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. A t 4 APPROVED APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN n L 10M mr" I r s BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY RIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFLCES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS.-- WITH PORCHES. GA- APARTMENTS t RAGES. ETC. SUPERIMPOSED. THIS REP",, CES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH - CONCRETE 3 1 2 13 CONCRETE SL K. —{ PINE BRICK OR STONE HARDW D PIERS PLASTER _ _ DRY WALL _ (7NFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA 1/1 1/1 '/. -FIN. ATTIC AREA NO 8 M FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 a DROP SIDING CONCRETE �_ - WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D � ll�— ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME - BRI K N'MASONRY ATTIC STRS. & FLOOR I_ J BRICK ON FRAME CONC. OR'CINDER BLK. STONE'ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 71 10 PLUMBING GABLE I HIP BATH Q FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) T FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO • 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE r� FORCED HOT AIR FURN. _ TIME BM S. STEAM - STEEL BMS.![COLS,;,'HOT W'T'R OR VAPOR WOOD --FTE AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS [�ELE AS istA T 13rd I No HEATING A FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: %�� a S l J� ZaJy) ru I b Phone 4x 7-7,6 LOCATION: Assessor's Map Number Parcel�� subdivision 1 pr►� Lot(s) Street /�, 1 ! G� St. Number D� _ ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved 2 a Conservation Administrator Date Rejected Comments _��`�ekc�— ►����%/1��Ll���/�,� Comments Health Agent Comments Date Approved Date Rejected Date Approved Date Rejected Public Works - sewer/water connections 0 - driveway permit '�-5 Jxad 4 r Fire Department Received by Building Inspector Date *13 CERTIFIED FOUNDA TION PLAN LOCATED IN kJ o ��-" �� »ov �rz , SCALE /""= 40' DATE Scott L. Giles R.L. S. 50 Deer Meadow Rood North Andover, Moss. k4 tGIGvCLQ %F I c., -- Loo.ov (L� N �t I N E.xl S-iT , N HgE.. �vp M 22,'1 'A6- LoT� DoT 5 � I i,o-7— T r �0 Ili;j � N 0 APR 2 im J / CERT/FY THAT OFFSETS SHOWN ARE FOR THE USE A% or THE OFFSETS OF THE BUIL DING /NSPEC TOR ONL Y o� y SHOWN COMPLY AND SUCH USE /S FOR THE WITH THE ZONING DETERM/NARON OF ZONING Es 0.13972 SY LAWS OF CONFORMITY OR NON- CONFORM/TY Ay�fCISTERE� WHEN CONSTRUCTED. WHEN BUIL T. 4121Q3 a a 0 z t � c cm CA -0 c y m m CD o CD CL ~ CD O i v o coa o a �cc V —J 10 .Q o ,C? ca Z CD 0 CL V y R_ C C _cc CL 0 J z r LU CL} CC z � o z LU Q W W z 0 0 LL a v o w or- co o x U a w o w �" c w a w > v �n w x p v o a c° w z w w c as o cn v ° cn a 0 z t � c cm CA -0 c y m m CD o CD CL ~ CD O i v o coa o a �cc V —J 10 .Q o ,C? ca Z CD 0 CL V y R_ C C _cc CL 0 J z r LU CL} CC z � o z LU Q W W z 0 0 LL a v i" V z Q a V 0 ots Q W IL z 0 W Q V LL W V T) I V) 41 �y , ' r ' =�;-• raj � Q� W Q� p O E=4 9 O -L O z uml CL •co �� o. N c o oq • - •a Ls CD m A� '~ V v H TV.) r y o� ♦ 1; E C3 CD 11 cm I WA -q% z �` � a o 3M M LCf).� y R T Q� C J •O tiC m Q ? r�-d r. h N W CC cm acoji c c hQ = W O O CO Q y O b- C•FZ o ..c 0o c a Q m `ymc o F" � „o H m o a� COOCc t r.. c +•+ P •v, O.Z�°•6 Z m U O LU `c c m c g CODC• _ o y•� O �- $arc t U J l.� co 0 z. E `L c o � z aLU O D ' c z � co Cm O w Cc CD cW w z> .0 o CD oC-) o O i O 0 CD 0 0 Q \ co O +-'0 cu Q. O � J L L y Z vQCD � O C= V ca � C (v •`i _� _ LL 0. ~ 4 CIO CD z z a' z u c CL v Oil - x O a C7 r" i ,� z ,� U �/ ,•., w . 0 - v v ro Uiw w w p w° ap' ap' C/) U) 41 �y , ' r ' =�;-• raj � Q� W Q� p O E=4 9 O -L O z uml CL •co �� o. N c o oq • - •a Ls CD m A� '~ V v H TV.) r y o� ♦ 1; E C3 CD 11 cm I WA -q% z �` � a o 3M M LCf).� y R T Q� C J •O tiC m Q ? r�-d r. h N W CC cm acoji c c hQ = W O O CO Q y O b- C•FZ o ..c 0o c a Q m `ymc o F" � „o H m o a� COOCc t r.. c +•+ P •v, O.Z�°•6 Z m U O LU `c c m c g CODC• _ o y•� O �- $arc t U J l.� co 0 z. E `L c o � z aLU O D ' c z � co Cm O w Cc CD cW w z> .0 o CD oC-) o O i O 0 CD 0 0 Q \ co O +-'0 cu Q. O � J L L y Z vQCD � O C= V ca � C (v •`i _� _ LL 0. ~ 4 CIO CD z z a' z u c CL v g Location 4141,� � U/` No, d� Date 7- ZZ 03 tet' TOWN OF NORTH ANDOVER TOTAL f Check # 2 Z 4 '1655-' H /5�v Building Inspector �. Certificate of Occupancy $ �7 SACNUs 4� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL f Check # 2 Z 4 '1655-' H /5�v Building Inspector -� TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING h r; 1 ,t BUILDING PERMIT NUMBER: O �/� DATE ISSUED: 9 `.a 04-1 O C SIGNATURE: AA Building Conuruissioner/IEE22ctor of Buildings Date SECTION I- SUE UNFOKMAIION 1.1 Property Address: 10,5 % C 'zrIc ( I 1.2 Assessors Map and Parcel Number: d)6 Map Number Parcel umber 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required I Provide Required I Provided Required Provided 1.7 Water Supply M.G.L.C.40. �1 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System Public ❑ Private 0 Zone . Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSIIIP/AUTHORIZED AGENT 2.1 Owner of Record -f &A Name (Print) Telephone 2.2 Owner of Record: Naora Print ' SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Lit nsed Construction Supervisor: Address re Telephone 3.2 Regijtered Home Improvement Contractor Company Name ZZ Cw '1% 9,Z6. N.H. Address A. „ _ /0 -'>- Address for Service Address for Service: 2 - (5 9'/ -,S 7"o Not Applicable ❑ ,�,9 Z)) - J License Number , Expiration Date Not Applicable ❑ /023.3 Registration Number 2-A o Expiration Date 00 M Z O 0 X_ Q a m n� K./ W O z M O on ic r v M r z 0 SECTION 4 - WORKERS COMPF,NSATInN nvr r_ r r 1417 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildingpermit. Signed affidavit Attached Yes ....... No ....... 0 SECTION 5 Description of Proposed Work check all applicable—) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of ``Proposed Work: i r r11 h zI�� �Y! `mac J Zq l 19 i /2.44 -*/- SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant (a) Building Permit Fee 1. Building p 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbin Building Permit fee (a) X (b) " J �D / 4 Mechanical HVAC 5 Fire Protection 6 Total . 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, , as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building pennit application, Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION e /J P E 7 N E h% 1a+Qaw=0Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief - 1<f"N�� t3 �� �- ►y Print Name /%4 M NO. OF STORIES BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION SIZE OF FOOTING MAT.ERLAL OF CHEVINEY IS BUILDING ON SOLID OR FMLED LAND 1S BUII .DING CONNECTED TO .NATURAL GAS LINE 7 // - Date SIZE 2"" 3 THICKNESS X FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits fron Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *APPLICANT FILLS OUT THIS SECTION APPLICANT, PHONE LOCATION: Assessor's Map Number 0-A Z PARCEL -&7 SUBDIVISION �nJ LOT (S) STREET �O n� 4j 6 d , ST. NUMBER. '"t �► " "'"`* *******OFFICIAL USE RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS} TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED. DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILL.,....,.,,, Revised 9197 jm TE Town of North Andover Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. FOR ROOFING, SIDING, INTERIOR REHABILITATION PERMITS 1) BUILDING PERMIT APPLICATION 2) DEBRI REMOVAL FORM 3) WORKERS COMP AFFIDAVIT 4) PHOTO COPY OF H.I.C. AND/OR C.S.L. LICENSES 5) COPY OF CONTRACT 6) FLOOR PLAN OF PROPOSED INTERIOR WORK FOR ADDITIONS / DECKS 1) BUILDING PERMIT APPLICATION 2) FORM U 3) MORTGAGE PLOT PLAN (MINIMUM) 4) DEBRI REMOVAL FORM 5) WORKERS COMP AFFIDAVIT 6) PHOTO COPY OF H.I.C. AND C.S.L. LICENSES 7) COPY OF CONTRACT 8) FLOOR/CROSSSECTION/ELEVATION PLAN OF PROPOSED WORK WITH SPRINKLER PLAN AND HYDRAULIC CALCULATIONS (if applicable) 9) MASCHECK ENERGY COMPLIANCE REPORT (if applicable) FOR NEW CONSTRUCTION (SINGLE AND TWO FAMILY) 1) BUILDING PERMIT APPLICATION 2) FORM U 3) GROWTH MANAGEMENT BYLAW 4) CERTIFIED PROPOSED PLOT PLAN 5) PHOTO COPY OF H.I.C. AND C.S.L. LICENSES 6) WORKERS COMP AFFIDAVIT 7) TWO SETS OF BUILDING PLANS (one to be returned) TO INCLUDE SPRINKLER PLAN AND HYDRAULIC CALCULATIONS (if applicable) 8) COPY OF CONTRACT (if applicable) 9) MASCHECK 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 application. 9 .1-1\ -27 KEEN CONSTRUCTION CO. 21 HEWITT AVE. N. ANDOVER, MA 01845 (978) 691-5201 Lynch, Ed & Diane 105 Hickory Hill Rd. N. Andover, MA 01845 (914) 497-0519 (cell) Contract # 1578 : Appendix A Date: 6/30/03 Finish basement: • Frame partition walls in basement to create two finished rooms totaling @ 580 sq. ft. • Boiler room, laundry room and closet under stairs to remain unfinished • Insulate & install'vapor barrier on all exterior walls • Frame & install two Andersen A41 awning windows on opposite side walls • Supply & install exterior trim and patch siding around new windows • Hang blueboard on all finished walls • Skimcoat plaster blueboard to smooth finish • Skimcoat plaster exposed cement foundation on stairway to match existing • Supply & install four interior 6 -panel hollow core smooth door units • Supply & install four Schlage passage sets on doors • Supply & install trim on doors, windows and baseboard to match existing • Supply & install 2'x 2' revealed edge suspended ceiling throughout finished area • Paint walls and trim(2 neutral colors, 2 coat finish) • Supply & install carpet in finished area including stairway($1600.00 installed allowance) Electrical: • Supply & install outlets to code, • Supply & install four cable outlets & five phone (Cat. 5) outlets • Supply & install two 2' fluorescent lighting fixtures in office U • Supply & install ten recessed lighting fixtures in family room • Supply & install two thermostats and wiring for two zones of heat off of existing boiler • Supply & install switching to code Plumbing: • Move existing sillcock on back wall to fit inside wall • Move gas line in family room above ceiling • Supply & install two zones of forced hot water heat off of existing boiler • Supply & install five new sprinkler heads in suspended ceiling Price does not include cost of permits, hardwood flooring, wainscoting, smoothening of stairway or exterior painting. All extras to be paid in full upon ordering. 1 KEEN CONSTRUCTION CO. 21 HEWITT AVE. N. ANDOVER, MA 01845 (978) 691-5201 Total Cost:$19,402.00 (nineteen thousand four hundred two dollars) Payment schedule:$ 1000.00 due upon signing contract $6000.00 due first day of work $2500.00 due when new windows are installed $3000.00 due when walls are framed $2500.00 due when rough electrical is complete $2500.00 due when blueboard is hung $1902.00 due at completion of contracted work l/enneth & een Da Date 2 L Nj The Commonwealth of Massachusetts Department of Industrial Accidents Arm #11vDBSt%yal/OBS 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit city phone # ❑ 1 am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity Failure to secure coverage is 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 1. certify under : pai sland penalties of perjury that the information provided above is true and correct. SignatureDate -7 , . f t '—1 Print names -/J Ni < t ��C Phone # _ _/ 7LO I official use only do not write in this area to be completed by city or town official city or town: permit/license # _ nBuilding Department CO] check if immediate response is required 01,keinsingBdard' contact person: (revised 3/95 PIA) ❑Selectmen s Office []Health Department phone #; Other Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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 section 25 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 nui produced acceptable evidence of compiiance with the insurance coverage required. Additionally, 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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address. and phone numbers as all affidavits 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. City or Towns 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 permii/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. yi,.,,iF�y.�aG 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 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ✓fie -611 1111 1 1/11U(.�zd�-alll BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR E Number: CS 058245,. Birthdate: 03/24/1943 51�Expires; 03/24/2004:;_ Tr.20021 Restricted: 00 KENNETH B KEEN 21 HEWITT AVE ` N ANDOVER, .MA 01845 Administrator. Board of Building Regulations and standards j HOME IMPROVEMENT CONTRACTOR Registration: 108383 Expiration: 8/1-8/2004 Type: DBA KEEN CONSTRUCTION CO Kenneth Keen 21 Hewitt Ave i No. Andover, MA 01845 A,droinistrato.r KEEN CONSTRUCTION CO. n 21 HEWITT AVENUE NORTH ANDOVER. MA 01845 Tel: (978) 691-5201 Fax: (978) 682-3231 Submitted�- To: - a 5 .._.; �Co_.__ _... I- �_� l _ Rd d_v r, . �Yl.. _ o;.._ . 15-78 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. HONE �1 DATE REGISTRATION NO. F.I D. N0. 90)q`5`7�— o 517 (c e I () 6-3o—o,3 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: _. 1 ✓1 I .S�.n7erl __ ._ > Construction related permits: WORK SCHEDULE Contrac r A�agrees work or order the materials before the third day following the signing of this Agreement, unless specified her wri o or 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 acknowledgat 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 n The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of r e. 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 a o i Y) Q_A _en a y-) t yso DA -ou r hfmd" +wp dollars ($ I J, L©z (oc) ). Payment to be made as follows: % ($ ) upon signing Contract; '(/�1 KENNETH B. KEEN �J Name of Contractor / Designated Registrant % ($ ) up com e o 21 HEWITT AVE. Street Address %((a/,�/✓1O��) upo`nTco>pl ion of N. ANDOVER, MA 01845 �SJ City /State % ($ ) 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 Namen4Salesman 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 A ,or 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 thistran i n. Ca ellation must be done in writing. D NOT SIGN THIS CONTFACT IF THERE ARE ANY BLANK SPACES. Ae� r---� Date IMPORTANT INFORMATION ON BACK O z i� : c o : C H _O C r.+ O v V CLC • O O ;= O O � m CF ` V .tog - :� y C C2 : 2s c E m C �mm a C m J =0 W4V cay Co O = C r y o . �Em v m �a0` m VJ m m r=+I'D . O Of CM � � C 4WAW r C H Q ac.c m O E m cjjyV� O G O Z O "- Of ` C3 C d O C Q `mc o N ~ v y m w m COD y t m W C :+ 'O O � � •y dt OLl* 00 C O Z CIO m a 0 C.I.- '- C5 H C.�m 0 3 r�� O D y CD .y CLL O CL h O Q .Q y O C..7 cc - cc a _ d h L O V co y C 0 co O � 3� O � O a ora C c cc OO Z Q CO)CL C 0 U) U) crw W CcW U) O w U C/) Uw" u: w" a w C/)w d0 0 w ii C cq cn -h4 o cn : c o : C H _O C r.+ O v V CLC • O O ;= O O � m CF ` V .tog - :� y C C2 : 2s c E m C �mm a C m J =0 W4V cay Co O = C r y o . �Em v m �a0` m VJ m m r=+I'D . O Of CM � � C 4WAW r C H Q ac.c m O E m cjjyV� O G O Z O "- Of ` C3 C d O C Q `mc o N ~ v y m w m COD y t m W C :+ 'O O � � •y dt OLl* 00 C O Z CIO m a 0 C.I.- '- C5 H C.�m 0 3 r�� O D y CD .y CLL O CL h O Q .Q y O C..7 cc - cc a _ d h L O V co y C 0 co O � 3� O � O a ora C c cc OO Z Q CO)CL C 0 U) U) crw W CcW U)