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Home My WebLink AboutBuilding Permit # 8/24/2015 t%ORTH B �ED .1 UILDING PERMIT "'T ,616 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#. 7,6 Date Received STEP SSgCHUS Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes MAP PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building [I One family [I Addition El Two or more family El Industrial El Alteration No. of units: El Commercial �)Repair, replacement El Assessory Bldg El Others: El Demolition El Other "NO $ "'M DESCRIPTION OF WORK TO BEP RFORMED: pp k re-, , Q e- we ft 6 e 33 L'J A V Identification- Please Type or Print Clearly t 7 OWNER: Name: r- c)r-JOS Phone: 6 3,3 5— 765 A Address: 16 5 e') N Contractorame: � �i 6�15'JA14fc)n Phone: Email: 5 '11 5 Ve6, e6", Z5'f i <t,) Address i' f�\ O'� Vie C-)' + A I Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 0 C -.—FEE: $ Check No.: Receipt No.Qq " V�- a n NOTE: Persons contracting with unregistered contractors do not have access to an fund ......Signaturwa FORTHTown of �1 ndover ® ® c0Z 45— 2b _ b LA , h ver, Mass, CdCKI C MI WICK S U BOARD OF HEALTH Food/Kitchen PE Septic System % D THIS CERTIFIES THAT ... IT . ...... .............. „ BUILDING INSPECTOR ....... .............. ...®. . ....... ..�... ..®.. . .. . ..... .... .. has permission to erect ..buildings on • Foundation Rough to be occupied as ............ ..... :.. .... ........® .. ......., fit.. . . ... . .... x.9.4............... Chimney provided that the person accepting this permit shall in every respect conform to the terms V the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Ins ection, Iteration and Construction of Buildings in the Town of North Andover. ®'1�y ® /- Cr. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. �w Rough Final PERMIT E I IN 6 MONTHS ELECTRICAL INSPECTOR LESSRTS Rough G Service ............... ... ................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or D Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. � 1 KEEN CONSTRUCTION CO. ° 1175 TURNPIKE STREET NORTH ANDOVER, MA 01845 All home improvement contractors and subcontractors Tel: (978)691-5201 engaged in home improvement contracting, unless Fax:(978)682-3231 specifically exempt from registration by Provisions of Chapter 142A of the general laws, must be registered Submittedd M r_ C'(V Yr C with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the L I Director,Home Improvement Contract Registration,10 C �U r c�� Y1 Park Plaza, Room 5170, Boston, MA 02116 617-973- 1 (1 8787 Owners who secure their own construction \\ A C ti e r Al I� 0 1 �:��7 related permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c.142A. PHONE DATEREGISTRATION NO. EIN NO. 2 t ?DI� MA. H.LC. 108383 46 —3783401 > C/S=Customer Supplied S+I=Supply+Install [�(See Attached Appendix A We hereby submit specifications and estimates for work to be performed and materials to be used: f > Construction related permits: '—,.__..—..._-----_..---_'_—...__.._.__.._..___._._......__._._._.___.....__................_._...._.__.........._....._....._.._...__......_....__..-.__:------------_...._...__.._._...._..__..___....._._.________..----_..........._..._..__...._.._. WORK S HE{{��ULE Contract 17W b¢�gin the work or order the materials before the third day following the signing of this Agreement,unless specified her!) Ng. patraclor will begin the work on or about ////��, Il�ll 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(hat are not avoidable by the Contractor shall not be considered as violations of this Agreement. WARRANTY K"' The Contractor warrants that the work furnished hereunder shall be free from detects in materials and workmanship lora 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 Contractor,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 f1—_1 V1 d JSC vl O ( Ol)r` 141 l C1 V C� Jewy� ( 1 _` dollars($ 2 0 Payment to be made As follows: /° ($ ) upon signing Contr ct; ROBERT A. KEEN Name of Contractor I Designated Registrant /° ($ upon Foomppi-t"'. f, 1175 TURNPIKE ST. Street Add(ess ($�� y� N. ANDOVER, MA 01845 portn ofJjCiry/State shall be made forthwith upon (978)691-5201 (978).682-3231 ($ ) completion of work under this contract. Phone IFax Notice: No agreement for home improvement contracting work shall require a I�O iJe l/ c:, >down payment(advance deposit)of more than one-third of the total contract price Name of set sm or the total amount of all deposits or payments which the contractor must make,in L advance,to order and/or otherwise obtain delivery of special order materials and Autlbof6ed sghatur equipment,whichever amount is greater. 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 sig 'ng,this proposal becomes a binding contract. You are authorized to d0 the work as specified. Payment will be made as outlined above. You,the Bu er, m ca el this transaction at any time prior to midnight of the third business day after the date of this trait �c o C cel a ion must be done in writing. 0 N T SIGN THIS CONTR CT IF THERE ARE ANY BLANK SPACES. Signature Dale I Signalure Date IMPORTANT INFORMATION ON BACK Consfracfion Co. KI?MOI)Ii1JNC: SI'GGIALIS"1"S Ke enConstructionCo.com Cordaro, Emily 105 Carlton Ln. N.Andover, MA 01845 Contract#5751; Appendix A July 28, 2015 Window Replacement: • Supply& install thirty Harvey Classic double hung replacement windows • Supply& install one Harvey Classic replacement picture window • Supply& install two Harvey Classic hopper(basement)windows • Remove doors and deck on front garage, re-frame and supply& install one Harvey Classic new construction unit with double hung window flankers and picture window center(approx. 96"x 51"), patch interior wall and install trim to match existing • Remove existing quad casement in kitchen, supply& install Harvey Classic new construction triple casement and trim to match existing • Remove existing double casement in kitchen, supply& install Harvey Classic double casement and trim to match existing Total Price: $20,475.00 (twenty thousand four hundred seventy five dollars) All windows will have white 5/8" contoured grids between the glass, %screens on the double-hungs,full screens on hopper and casements. We will insulate around new windows with spray foam and remove all construction related debris.This quote does not include permits, painting,windows in master bath or repairs to any unusual, unsafeor n n-code compliant existing conditions not addressed in this quote. Payment Schedule: $4088.Q&due upon signing contract '-'-,CO $50.OA due when windows are delivered $4500.00 due when replacement windows are installed $3975.00 due at completion of contracted work i JFr� iI Cust er Robert A. Keen ?/2-Date Date 1175 Turnpike St. Page 1 of 1 P: 978-6091-5201 N.Andover, MA 01845 F: 978-682-3231 GSL #0760091 Sales@KeenGonstructionGo.com HIG #108383 The Commonwealth of Massachusetts - Department oflndustriglAccidents 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/Organizationff dividual): G-e_V) �CM J +ru Address• b',ITC City/State/Zip: U 6 FISI a 6] ';J6 Phone#: �7 �_ 6�J�5 2-O Are you an employer?Check the appropriate box: Type of project(required): 1.[� 1 am a employer with _ F11 am a general contractor and 1 6. El New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor orpartnor- listed on the attached sheet.+ 7. [Remodeling ship and'haveno employees These sub-contractors have 8. C]Demolition working for me in any capacity. workers'comp.insurance. g Building addition [No workers' comp.insurance 5. El We are a corporation and its 10.E]Electrical repairs or additions required.] officers have exercised their 3.01 am a homeowner doing all work right of exemption per MGL 1 l.[]Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.QRoofrepairs insurance required.]; employees.[go workers' 1311 Other comp.insurance required.] 'Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. T'Homeowners who submit this affidavit indicating they lire doing all work and then hire outside contractors must submit a new affidavit indicating such. ?Contractors that checkthis box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that ispioviding woArers'compensation insurance formy employees. Below is thepolley andjob site information. Insurance Company Name:. V 1 (1 1�'1 ��s� s�G �y Policy#or Self ins.Lic.#:� .v / ��j'z-�+xpiration Date: 1 7 Job Site Address: ®� C r � ) City/State/Zip: A �)U Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL o.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. Ido Hereby cert un er tepai and aides ofperjury that flee informationprovided above is truef and correct. - Signature: Date: Phone# � Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Cleric d.EIectrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: RightFax C3-1 3/24/2015 9:51 : 03 AM PAGE 2/002 Fax Server L CERTIFICATE OF LIABILITY INSURANCE ATE(MM/DDNYYY) T. 1IFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER, D 1HE CERTI[ICATE HOLDER IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). PRODUCER CONTACT NAME: GILBERT INS AGCY INC PHONE FAX 137 MAIN STREET (AIC,No,Ext): (A/C,No)- E-MAIL READING,MA 01867 ADDRESS: 246WY INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A. TRAVELERS INDEMNITY COMPANY OF AMERICA KEEN CONSTRUCTION CO INSURER B: INSURER C: INSURER D- 1175 TURNPIKE STREET INSURER E: NORTH ANDOVER,MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS is TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MMWD\YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR. PREMISES(Ea occurrence) ED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY F]PROJECT[:]LOC RODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ 71 (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE ._— $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION ANDWC STATUTORY OTHER EMPLOYER'S LIABILITY YM UB-999JM582-14 10/08/2014 1010B/2015 X LIMITS ANY PROPERITOPdPARTNERIEXECUTIVE N/A E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1600 OSGOOD STREET BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTA NORTH ANDOVER,MA 01845 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORPORATION. A]Irights reserved. Massachusetts -Department of Public Safety Board of Building Regulations and Standards l.l)lllll Il l'tl ll 11 JI/11C1 V1�1/1 License: CS-076691 ROBERT A KEEN,-`- 12 E WATER ST 3 �$ 3 North Andover Na 0 r � O y. Expiration Commissioner 08/16/2017 �e�par��w�uuecc o/bAiaacccf uaeCYa Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR egistration: 108383 Type: xpiration 8/1$/2016..' DBA 1 == 1 KEEN CONSTRUCTION CO Kenneth Keen =` 1175 TURNPIKE ST � �s-- NO.ANDOVER,MA 01845`'—` Undersecretary