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HomeMy WebLinkAboutBuilding Permit # 4/26/2016 F t%®RT H Town of Andover ® _ n ver, 26(411 . 0 1.ANQ a 9 SSS' COC NIC N$WIC O( x,95 R-iTED %1%1 " U BOARD OF HEALTH PEK T Food/Kitchen kTrSeptic System THIS CERTIFIES THATBUILDING INSPECTOR .................. .. kj.. ........w................ ... .. ......... ......................................... has permission to erect ..�. , Foundation ................ ........ buildings o ....... .. .... . ............... . . .. ............® _ o • Rough to be occupied as .. . ... 4. ... ......... .. ...... ... ..�,�.1 . . .�.�,.... .. ..... .... .... ... Chimney provided that the person accepting this it shall in every respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough /� Service ..........................s� � � .............. .......L......... ..... Final BUILDING INSPECTOR GAS INSPECTOR ccupancy Permit Required t® Occupy BuildinLy Rough Displayin a Conspicuous Place on the Premises — ®o Not Remove Final Lathing or Dry Wall To Be ®one FIRE DEPARTMENT Until Inspected and Approvedthe .Building Inspector. Burner Street No. Smoke Det. redera I ID#05-0406029 IMSE En ulcering RI Contractor Registration No 8186 MA Contractor Registration No 120979 RISE k division orThicIsch E*Rgiricering ENGINEERING 60 Shaivinul Unit 112,Coulon,MA 02021 CONTRACT 339-502.6335 FAX 339-502-6345 Page I PROGRAM 1 1TRAMS EtITEREDINTO BETWEN RISE f a15 CM 41 OVIA-1 IES E?GINEERINGANDIRIE CUSTOMER FORWORKAU DESCRIBED BELOW CUSTOLICA PHONE DATE CLIENT II WORK ORDER Ajaykumar Paid (862)219-0546 02/19/2016 4295,10 00002 SERVICE STREET BILLING STREET 88 Peachtree Lane 89 Peachtree Lane SERVICE CITY.SIAM ZJP BILLING CITY,STATE,ZJP North Andover,MA 01845 North Andover,MA 01845 JOB DESCRIPTION 11FAL'I'll&SAFETY:Weatherization work cannot proceed until mechanical ventilation That will provide(1)crin(cubic lest per Ini;lIde)or continuous air flow has been installed in your home.ADD A BATIf FAN DFISIGNED FOR CONTINUOUS TION 060 Cl- TIMI -0 CYCLE 22 MIK 1WHY 110111t,ONF,SUCK[--AN IS PANISONIc OPPERA g Wt THIS CAN HE ON A At'1'O WI IISpFR SU'LliCT,CAN FIND AT ETLORGOft AMIZON,COM. 50.00 I IAZARD BARRIER:We have identified that there are recessed lights present in your home.unless file recessed lights are certified its IC-rated(Insulation Conlact Rated)we will create a 3"clearance space around the fixture by using fibcrf;I;e;,,blanket insulation its it damning material,no insulation will be installed across the top and closed cavities which contain recessed Ii .00 Alit SliALINQ provide labor and materials to seal areas ofyour hone against wasteful,excess air leakage. sc 1;will be PoV performed in concert with file use or slice i ill tools and diagnostic tests to assure that your home will be left w t I A air exchange and indoor air quality.Materials to be rise(]to sea]your home can include caulks,foams and of 1) areas for Scaling include air leolinge to allies,basernerds,attached garages and other indicated areas(windo% re addressed.) 11iis will require(12)working hours.A reduction in cubic feet per minute(cin)ol'air infillrati vii Cur,but the actual number orclim is not guaranteed. Eur At tire completion of tine%watherizinion work,and at no additional cost to the hoincroviler,a final blower& )r and/or combustion s,Qty analysis will be conducted by the sub-contractor(I)ensure(tic safiely of the indoor air quality. $1,020.00 ATFICITAT:provide labor all(]materials to insw-U11-1--"—layer orIt-12 Class I Cellulose added to(120)square 1cet of floored vatic space. $236.40 ATTR:FLAT:provide labor and Diaterials,to install a 9"layer Of R-30 onfaced fiberglass Batts to(72)square feet of title space. 5120.24 KI-rIC FLAT:provide labor and materials to install it 4"layer of R-14 Class I Cellulose added to(565)square fect of'open attic Space. $638,45 KNITWALLS:provide labor and materials to install 2" FSK faced scini-rigid fiberglass board insulation in(210)square feet of lincewall area. SM,00 ATTIC ACCESS:provide labor and materials it)insulate(4) back orthe kneewall hatch with 2"rigidThennax board,and seat file edge of the hatch%%-ill) $2,10.01) ATHCACCESS:provide labor and materials it)make(1) access opening,limn one antic arca to another 1)),coning it passage Through sheathing. This access will he tell open as it is between two Common tuflicaled noll rifewalled attic areas. $31,31 VENTILATION:Provide labor nand rnaierials ill install ventilation chores in(28)rafter baYs to maintain air flow, $56.00 Federal ID#05-0405629 RI Contractor Registration No 8186 MA Contractor Registration No 120979 RISE A division ol"FlOrIsch EIRgioerring ENGINEERING 60 Shawinut I 4iil 02,Canton,NIA 02021 CONTRACT 339-502-6335 FAX 339-502-6345 Page 2 III(MRAM TRIS CONTRACT IS ENTERED INTO BETWEEN RISE CNIA-11ES ENGINEERING AND THE CUSTOMER FOR WORK AS DESCRIBED BELOW CUSTOMER PHONE DATE CLIENT 0 WORK ORDER AjaykUniar Patel (362)2 19-0546 02/19/2016 429540 00002 SERVICE STREET BILLING STREET 88 Peachtree Lane 88 Peachtree Latic SERVICE CITY,STATr.ZIP BILLING CITY,STATE.ZIP North Andover,(VIA 01845 North Andover,MA 01845 JOB DESCRIPTION COMMON WALLS:Provide labor and materials to install 2"FSK faced semi-rigid fiberglass board insulation to(240)square Ileel of Common wall area. $840,00 RISE 1:11gincering will apply ail applicable,eligible incentives to this contrad. You will only be billed file Net amount. Currently, I'm cli"ible measures,Columbia Gas offers 75"%incentive,not to exceed 52.000 per calendar year,and an incentive or 100%flor the Air Scaling measures till lo file liml 5680 and an additional$340 iI'S;IViRg.i IIrCjLISfiIlcd by the auditor. For the safety and bealtli oryour horne's indoor air quality,We will be conducting:I blower door diagnostic ol'the available air flow in your home both berore the work is began,;in(]alter the weatherization Work is complete.We will also conduct a felt assessment of the cornbus6on salety ol'your heating system and Water beater.This has 11 Value ol'$90 and is at no cost to you. Total allowable weatheriyiRion incentive is$3,110. $90.00 2016 Total: $4,007.40 Program Incentive: $3,110.00 Customer Total: $897.40 IVE AGREE HEREBY TO FURNISH SERVICES COMPLETE In ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF '"Eight Hundred Ninety-Seven&401100 Dollars $897.40 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEEAING.CUSTOMER AcRet-i'vo REMIT AMOUNT DUE 101 FULL-INTEREST OF 11,'.WILL BE CHARGED MONTHLY ON ANY UNPAID DALMFTER 30 DAYS. -E REVERSE FO IMPORTANT INFORMATI16a ON GUARANTEES.RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DUN- 1911`614 THIS CONTRACT IF THERE ARE ANY QLANK SPACES A7 FNZEDSIGNAI R -RISEF eA.D NOTE;THIS CONTRACT MY tlE WITHDRAWN BY US IF NOT EXECUTED WITNIN DATE OF ACCEPTANCE ACCEPTANCE or CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE 30 SAR FACTORY 70 US AND ARE IIEREBYACCEPTEO.YOU ARE AUTHORIZED TO 00 TRE WORK DAYS. AS NECtFIED,PAYMENT WILL BE MADE AS OUTLINED ABOVE ISE 60 Shawmut Road,Unit 2 I Canton,i A 02021 (339.502.6335 ENGINEER NG www.RiSEengineering.com OWNER AUTHORIZATION (Owner's Name) owner of the property located at: (Property Address) • JAY✓© "Y4 . �L�'c'G✓`• (Property Address) hereby authorize l-L fL!�M'V- I V`"-_ (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property.This form is only valid with a signed contract. eL 1,9A Owner's Signature Date The Commonwealth q '.Vassachusetts Department of Industrial.-#ccidents *1 in vestlgatiollt s 1r t 1 Congress Street,Suits" 100 Boston—VA i Workers* Compensation Insurance Affidasit: Builders C t)ntractors;l,lt:ciricians�Plumht'rs applicant Information Please Print Legibly Name Iliil•il t.Y1�..L_ia1, A_Kq0-t-��i'_1"�.----_._---_. Aditus:- 6 0)( 3TI _ I tty Stmtt 71p.. iS�"J i `7 f (�t 3 Phone (P. k; 3 are.,ou.111 emplo.1W!Check the appropriate box: I'rpe of project treyuiredr ® i.ar, CrlcrJ r,d I (, []\C"', a n.trlltl,yrt cnipl o% I..111 J11d.tJr Ik¢'.i; lil - 01C ❑iI lCn1i le(Uri 1 am J ;t,lC F-01-In'Jor ur' utstr:' I�,tzd n:h� aLxl�_'.,iuei (��:n_�.ticliau 0 C)rrrl,­!-It:till t':nrkl'12 10r I17C'iii ar€t �;t U�ll`.. 1 t f i � it;ddi t!:Iddl uin ltttlh f. Ir3'.I ��.:':4l it RCr�. Ct-tlll}l. tlblticlltC ill'dd�l llls:�tl� i j`.t1 3 tltii T'tCil151`.1( JCIiT?l._t1: .hTi! ( ,• I.C) t ltwl'o'lW t jai ,r.r:T•.tJ�llr�n; C _II'`: -CiC??St tl ^.C: `ICIL ,1,5_'i1 i`at•A,�r1 i rs .?tiYj` imuran:: rcyu rtJ) ' 1 15, 11411 Ind .tc II&,C uv Oft)t C t'tTitl. Ili>:Y;:Y 3111 t;yi;Y Crv.� � r,: 11 F­1 .,_, 'ids=u .,.9:1.... � •.L'%,ii, t ..'f_' i sl-:'.! r. .....•- t.. i ",r�._�. ...,_ ..�....- C �.f ...,...... s ,_'.'�'.�, ta_- .. i 't.'.. ..7 ii ,. I um art emph?rer that ii providing nwrkerscompensation insurance tar ort'entplorecr. Behviv is the polio'and job site itt f orntatiom q Inalrsn�c l unip,ai� ;1.t:a1.._. ]gyp i`4t(k. 3tii}tsyvl�'G�nt 1 o ,l..l� .- ---- ------ �€It 1[ti�.i L)•It6'. _� �7��� /� I.. .hr_e� i, `►'� ,C, � ! C) wash .t cope of the iiorkeW compensation polis} declaration page(41imin;>the polic} numher and ccpiration dates. I eilurr:r ,marl :�•.cr tom. 1, i.°<Iltireti uaJ�'r 5�•titin�;.t : VOL i1;:.<J.,,lLk: trIlpf,ititr.l...1�1 an+Iasi p�'��;11ttt iillr aj)(it S,,51111 00.)IM Lt!_l,, c 1� 'r-��:i,t;r TT.n.. ;:w . cA e;CI%A la thV :*1"till a SHIP%`i I)RK t=1PDFR .rid i ;'I :n�to S_­000;1 i,,y tnc t uflLltt1-_ Ba.1th i vd ti.a!a Lop" II)XI. h: 10lkt.iniet'tO tht-t r '-<c 411 Inl•rsu:at:.>ns 11te f)i�\ for I rlu hereb,v cerir'fl'w0er the pains and penalties of perjurt•that the infitrmation prt viirled above is true and con-vet. Official asR onh'. Da not n rite•in this arca,to he c oniplete'd hs city or tow noff ficial Cit1 or`fossn: _____ Permit-l.icenwc 14euing kathorits (circle one): I.Board of health 2.Bltilding Department 3.Citi'io n Clerl, _I.Electrical Inspuctor 5.Plumbing;lnspector 6.Other Contact Person: __..__— Milne if: ACERTIFICATELIABILITY INSURANCE DA7 7//7/27/20/01155 THIS CERTIFICATE 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,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Nancy Usher Martin J Clayton Insurance Agency, Inc. {PHO Na,Exll; (413)536-0804 �� No (413)534-7874 1649 Northampton Street E-MALADDRESS:. — ___.. .......... -- P. 0. BOX 989 INSURER(S)AFFORDINGCOVERAGE NAIC# . Holyoke MA 01041-0989 INSURERA Nationwide Mutual-Harleysville .NATIO -- -- ...... _..- INSURED INSURERB:Allied World Natl Assurance Co Gauthier Insulation INSURER C: 44 ESSEX ROAD INSURERD: INSURER E: IPSWICH MA 01938 INSURERF: COVERAGES CERTIFICATE NUMBER:CL157701379 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. ILTR TYPE OF INSURANCE lu SUBR� POLICY NUMBER PO DD EFF POLDDY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A CLAIMS-MADE OCCUR PREMISES_(Ea occurrence)_ $ 50,000 X GL43487F 7/6/2015 7/6/2016 MED EXP(Any one person) $ 510 00 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- Loc ___ CO 2,000,000 .X POLICY�,JECT L.... PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea__acciden�_ ANY AUTO BODILY INJURY(Per person) $ - ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS AUTOS NON-OWNED _PROPERTY Ferr acc dentDAMAGE $ $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE .$ 1,0 00,000 BC EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,.000,000 DED RETENTION S BE020792125-194985 10/18/2014 10/18/2015 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY __.STATUTE -_ ER ..... ANY PROPRIETOR/PARTNER/EXECUTIVE IY(_N N/A __ ..E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ...... (Mandatory In NH) E._L._DIS_EASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CSG, NSTAR AND NATIONAL GRID ARE LISTED AS ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MASS SAVE PROGRAM THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CONSERVATION SERVICES GROUP, INC. ACCORDANCE WITH THE POLICY PROVISIONS. 50 WASHINGTON STREET WESTBOROUGH, MA 01581 AUTHORIZED REPRESENTATIVE Daniel Sullivan/MEG2 '° �; .� O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD MFrd(d9tbd with pdfFactory trial versionw ,',Lqff cAI _,gq CERTIFICATE OF LIABILITY INSURANCE 7Hj ._[RT-r-*CATE 11,!SSLj�,-I A.A!4 A ITEP. ill-%GNL., 1,C S jCN—ELc? 171'-7E Ti4i*; 'P.T'P:CATE D�DES 7-CIT Al-r1rVAT:,�-E-LI - -1TF "-MF D �177r, - R T�E 5 f T,,r�C—!,--E " S T 1,E 6 71 5 E F!,'!A-E C 1451UR-A`,C' i1�-IRIZED EE T-,:7 �'.E q-R;,�;� AuT, FA3 ESENTA71VE OR R kIND THE EKTI CA- 111,77RANT:If tl�cErttholt, sr�A-� must bE� 'S 1NArj:-l. T :3'h= I s and cc,dtons d to pnlc,.cerTa n y A 7tZtEEp!-n'pjr ,&,f do c" ghL t, 1,�,ce,1,hfFu 77— ' A�s,-,ned P,4. Clayton Martin J Ins Agency Inc 1649 Northampton St PO Box 989 Holyoke MA 010411 Cc,-, Gauthier Insulation Inc PO Box 344 = 1 lipsmicht MA 011938 COVERAGES CERTIFICATE NUMBER REVISION NUKBER I H�IS T G C =}T _ F P-)L 1'-'I E S C.'F I PA%(:;-7 T 7 PErl -F r %I!Lc;TC`-.`-FC7 F C, a4-,ICAt Ti-ZTVCANPEMENT T C,71T 11Y VE I,I NIT,RF5rT,-! -F RTI-ATE MA PE -P VAI TH-E -E N is ti09-'�C:T -_USION�41,7) _`F S ES, Rf-[ ED T Auiom,41,-E uAse-,TY Uff 7 Ccuff.9 I— AhD EYES L4YVA4414416.�y L E CERTIFICATE HOLDER CANCELLATION Clearesult E ;i T;,-"r4 E'PE =__i_._.ED Contractor Svcs 50 Washington Street Westborough. MA 01581 ACORD's C 11,;9 ` '»*hams. a Of Wy \-rd of \/6 ga#om aay«ae\ . . .. ! °° a . r /rCSSf02562 . KURT RGAUTmk P#%.#4 2 In hMA 019 0512&a# ! Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 173410 Type: Individual Expiration: 10/1/2016 Tr# 257812 KURT GAUTHIER KURT GAUTHIER P.O. BOX 344 IPSWICH, MA 01938 Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card Office of Consumer Affairs be Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 173410 Type: Office of Consumer Affairs and Business Regulation Expiration: 10/1/2016 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 KURT GAUTHIER KURT GAUTHIER 44 ESSEX RD �;,,�� IPSWICH,MA 01938 Undersecretary of valid wi out signature