HomeMy WebLinkAboutMiscellaneous - 108 CHRISTIAN WAY 4/30/2018 (2) 108 CHRISTIAN WAY
210/104.13-0137-0000.0
1
Date....�!.....................
t
f ,&ORT►,
3?;•,;�``°-;' "�,� TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
,SSACMUS�
This certifies that ./
has permission to perform .......... ......::.....f...................... .�....................
wiring in the building of.........�... : .... '- D Lei�, ,,
..........................................................
r at........1�.e.................................. ...W.''-,t ..............
.......... ,,North Andover,Mass.
Fee....:✓ .. Lic.No.-A,7�.�0....l........ . :r't
ELECTRICAL INSPECTOR r
y Check #
N Commonwealth of Massachusetts official Use
/Only
NMI
Department of Fire Services Permit No.
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 11/991 (leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 8/4/2006
City or Town of: North Andover To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 108 Christian Way
Owner or Tenant Cathy Fowler Telephone No.975"-2524
Owner's Address Same
Is this permit in conjunction with a building permit? Yes X No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install outlets on outdoor porch,add mist.lights and outlets as re-
quested.
Completion ofthe-following table may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans Transformers KVA
` No.of Lighting Outlets 1-2 No.of Hot Tubs Generators KVA
Above In- o.o Emergency Lighting
No.of Lighting Fixtures Swimming Pool rnd. ❑ -gr d. E] Batte Units
No.of Receptacle Outlets 4-6 No.of Oil Burners FIRE ALARMS No.of Zones
c7 No.of Detection and
No.of Switches No.of Gas Burners Initiating Devices
Total
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers
Heatota P Number. Tons KW No.of Self-Contained
. Detection/Alerting Devices
Municipal
No.of Dishwashers Space/Area Heating KW Local ❑ Connection ❑ Other
No.of Dryers Heating Appliances KW NSecurity Systems:
o.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
,. Heaters Signs Ballasts No.of Devices or Equivalent
Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or E uivalent
' OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) On File Feb/2007
(Expiration Date)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: 8/5%2006 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: Kelly M.Casey Signature + LIC.NO.: 37200
(If applicable, enter "exempt"in the license number line) Bus Tel.No.: 978-697-4453
Address: 700 Robbins Ave Unit 3 Dracut Mass 01826 Alt.Tel.No.:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent.
Owner/Agent PERMIT FEE: 35.00
Signature Telephone No.
Ot ,AORTH 1ti
O
32 n}•• OL -
x TOWN OF NORTH ANDOVER
'•�; . .=•' APPLICATION FOR PLAN EXAMINATION
SS�CMUSE
Permit NO: Date Received:
Date Issued: L P19- O
IMPORTANT: Applicant must complete all items on this page
LOCATION !0
PROPERTY OWNER -A 1`ciQc1L =InW tL, ,.
Print
MAP NO.:_/a�}�PARCEL: )� -J ZONING DISTRICT:
TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
New Building G One family
Addition Two or more family Industrial
Alteration No. of units:
ACRepair, replacement C Assessory Bldg L Commercial
C: Demolition
C Moving(relocation) El Other Others:
Foundation only
DESCRIPTION OF WORK TO BE PREFORMED
t2p 1 1 ;n l2 M t r tt1
i
Iden Ccation Please Tyne or Print Clearly)
/s !� 4?
OWNER: Name: ( ,R �y � u �ut1 �fw Phone.Q�s'Z�LY
iSiature
Address: /O 4 C h�-i S i A a1 V J A
CONTRACTOR Name: l,L N NC a, !3 • 1�5..1� Phone: 6g/JL4�
c
Address: Z Y F W t 16 Al 6- jj . /4 M(ay C--L
Supervisor's Construction License: Z ` :.S- Exp. Date: 3 Z4
Home Improvement License: 1 D 3 3 Exp. Date:
ARCIJI'I'EC'T. FNGINF.FR Name: Phone:
Address: Rel;. No.
FEE SCHEDULE:BULDING PERMIT.510.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON
S'12.5.00 PER S.F.
Total Project Cost S 13 i� (a �- x10.00- FEE:$
Check No.: 7i Receipt No.: j
TYPE OF SEWARGE DISPOSAL
Tanning/!Massage:Body Art _ Swimming Pools
j Public Sewer __
Tobacco Sales Food Packaging;Sales
j Well
Permanent Durnpster on Site
j Private(septic tank,etc.
i
i
NOTE: Persons contracting with unregistered eontractors do not have access to the rtharanlp•fund
Signature of Agent/Owner Signature of.Contractor
Plans Submitted !❑ Plans Waived ❑ Certified Plot Plan ❑ tamped Plans ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF- U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ Lj
❑Water Shed Special Permit
❑ Site Plan Special Permit
❑ Other
COMMENTS
DATE REJECTED DATE APPROVED
CONSERVATION ❑ ❑
COMMENTS
DATE REJECTED DATE APPROVED
HEALTH ❑ s rl
COMMENTS
s
Zoning board of Appeals: Variance, Petition No:
Zoning Deeis.ion,receipt submitted yes
Planning Board Decision:_ Comments.
Conservation Decision: Comments
't ater&, Sewer connection signature&date
Temp Dempster on site yes__noK Fire Department signature.'date
Building Permit Approved and Issued by:
i
Building Setback (ft.)
Front Yard Side Yard Rear Yard
Required Provided Ret uired Provides Required Provided
DIMENSION
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
NOTES and DATA—(l,or de artment use)
i
I I
i
I
-- - -- -- — --I
I �
I
%•.� �;�:,I R�'I(.:I I'-11 T.l ;;I'h(;IZ.�I'I:�
Building Department
The following is a list of the required forms to be filled out for the appropriate permit to be obtained.
Roofing, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Debris Removal Forfn
❑ 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
❑ Form U
❑ Surveyed Plot Plan
❑ Debris Removal Form
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
• Copy Of Contract
❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic
Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
New Construction (Single and Two Family)
❑ Building Permit Application
❑ Form U
❑ Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
zi Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydrauli
IF 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 cope and proof
of recording must be submitted with the building application
Doc:INSPECTIONAL SFR\ICES DEP.IRTVE\T:BPFORN105
Location /Dif l► •�. �`r= �� �� '"
No. Date - •7v '
�oRTM TOWN OF NORTH ANDOVER
� 9
+4 Certificate of Occupancy $
� ; .
Building/Frame Permit Fee $ {
s�cNust —t
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # (�
r
ilding Inspector
t NORTH
Town of Andover
O
No.
A dover, Mass. '30 • 0�D
COCMI CKEWICK ' '
�d A�RATEO
S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
ry laftw BUILDING INSPECTOR
THISCERTIFIES THAT............... /............... ..................................................................................................................
Foundation
has permission to erect................................... buildings on ........�. ......, Rough
off...... ,�'
to be occupied as.... � A ... ......... �!! !��. N. .....,. ,,. .....,W!�A� Chimney
provided that the person cepting this permit shall in evryrespect conform o the terms of the application on file in Fin
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of al
Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
00*40 PERMIT EXPIRES IN 6 MONTHS Final
1 UNLESS-CONSTRUCTIO A4=461�NG
ELECTRICAL INSPECTOR
Rough
..................... ........... .... ce
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
Final
No Lathing or Dry Wall To BeDone FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
KEEN CONSTRUCTION CO.
21 HEWITT AVE.
N. ANDOVER, MA 01845
(978) 691-5201
Fowler, Paul& Cathy
108 Christian Way
N. Andover, MA 01845
(978) 975-2524
Contract# 1620; Appendix A Date:6/27/06
Remodel screen room:
• Remodel existing screen room(approx. 12'x 15')
• Create kneewall approx. 24" high on all openings except door opening
• Supply& install T & G knotty pine on kneewall and around windows (except on.interior
wall and ceiling)
• Supply& install seven Harvey white aluminum rolling storm windows (with tempered
glass)
• Supply& install one Harvey solid core storm door
• Remove all debris
Price does not include the cost of permits, painting, flooring or electrical work.
All extras to be paid in full upon ordering.
Total Cost:$7366.9 1(seventy three hundred sixty six and 91/100 dollars)
Payment schedule:$1000.00 due upon signing contract
$3000.00 due the first day of work
$3000.00 due when framed except windows
$366.91 due upon completion of contracted work
Customer 5oketh B. en
Date Date
_ The Commonwealth of Massachusetts
Department ofbidustrial Accidents
office oflmtestigations
- ,� 600 Washington Street, 21hFloor
iN ' Boston
� ,Mass 02111
Workers' Compensation Insurance Affidavit Building/Plumbing/Electiical Contractors
r�Pplicant m'fo/rmaf�ori: .{ '>' PleasePRINT`lebly
name:
address:' Z' L 14 N( 1�Llo
city Un(Ll / c f.)I/L state: ew,4 zia-P/�IyJ phone#9-72 O
work site location(full address):
❑ 1 am a homeowner performing all work myself Project Type: ❑New Constniction❑Remodel
l am a sole proprietor and have no one working in any capacity. ❑ Building Addition
❑ 1 am an employer providing workers' compensation.for my employees working on this job.
company name:
address:
city:
phone#•
insurance co
r ohc #
rnr... tf,..
❑ 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:
address:
city:
phone#•
insurance co #
Ohe
company name:-
address:
city:
phone#•
insurance co. policy#
Attachaddihonal s}ieet if necessary,.. .'. ksi.% "s r ti 7
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.
1 do herebycerti i the pains a d t es ofperjuty that the information provided above is true and correct.
Signature 100 Date Zj '-0 6
Print name / /V (5 Phone# ` ^
official use only do not write in this area to be completed by city or town official
city or town: permit/license# ❑Building Department t+;;
s
❑ ❑Licensing Boardcheck if immediate response is required ❑Selectmen's Office
❑Health Department
contact person: phone#; ❑Other
i (revised Sept.2001)
•. ..-.,at tx:.,.. ,. .:i'::r�',7€n�^�;�...!�.�"7F;�.n`'sn.::.c..:iti _:t K. t � y .
�1ze �omvmo�uuecz�i o���,a�t.;ucfccaef,�a �
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 108383
Expiration: 8/18/2008
Type: .DBA
KEEN CONSTRUCTION CO.
Kenneth Keen ;
21 Hewitt Ave
I
No.Andover, MA 01845 Deputy Administrator j
✓�ee:toair�rrro�uuea�i � ae�zuaelr6
BOARD OF BUILDIN _REGULATIONS
ricense: CONSTRUCTION SUPERVISOR
Number: CS 058245
3irthdate...03/24f1943
'Ex0Jres:`03/24/2008 Tr.no: 13436
Restricted-0'0--.-
KENNETH B KEENS 4
21 HEWITT AVE G,
N ANDOVER, MA 01845✓ - C - //
Commissioner
KEEN CONSTRUCTION CO. 1620
c 21 HEWITT AVENUE PROPOSAL
NORTH ANDOVER. MA 01845
Tel: (978) 691-5201 All home improvement contractors and subcontractors
engaged in home improvement contracting, unless
Fax: (978) 682-3231 specifically exempt from registration by Provisions of
_ ((' __ Chapter 142A of the general laws,must be registered with
Submitted ` i \ I ` the Commonwealth of Massachusetts. Inquiries about
4
To: .._.- .L......: ... ......._ .. _.._.{...__.-._. s..__:. _ .._. ----- registration and status should be made to the Director,
I ? Home Improvement Contract Registration,One Ashburton
��- ------ � J ..-.•-.----- .. Place, Room 1301, Boston, MA 02108 (617) 727-8598.
Owners who secure their own construction related
permits or deal with unregistered contractors will
be excluded from the Guaranty Fund Provision of
MGL c. 142A.
PHONE _ DATE REGISTRATION NO. F.I.D.N0.
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:
.......... . ..- —_._ — —._ .._�_... . .....
..�. �..,_—______._. -. ...._._..... t
........ .._._-...... .......,.. ..._.._ tt
> Construction related permits:
_......."._,........._....."............._..........".....................,..............."......"......"."...........................................................,.................................................................,.....................................,.........................................................................................._...."............................
WORK SCHEDULE t ...,�........a�....r....!.
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
acknowl dges 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 f r'C: 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
:.�4 I< i if J k ' I i i (-I
_2 /' .i }.___..�dollars($ /I
Payment to be made Ps follows:
($ ) upon signing Co tract; KENNETH B. KEEN
' Name of Contractor/Designated Registrant
, 21 HEWITT AVE.
($ )\upornc mpl tion o) �
s Street Address
N. ANDOVER
uRon�,completion of , MA 01845
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 Name or 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 Auth9ri2edSigrsature`—/-
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 ANY BLANK SPACES.
Signature '~ -� Date��`' � Signature Date
( IMPORTANT INFORMATION ON BACK NO-