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Home My WebLink AboutBuilding Permit # 6/2/2016 BUILDING PERMIT va TOWN OF NORTH ANDOVER 6 » APPLICATION FOR PLANE EXAMINATION -Permit N _ � Date Received 4 0 Date Issued: i i IMPnR Ap2licant must complete all items on this page DATION 360 Winter Vit, N®rth Andover, MA 01 04$ PR0PERTY O ER, Almy Harp, Print Print- MAP NCS PARC L Z NIOfS7�ICT: 1 H� , uric District ye no i Ma'hine Shaip�/iflage yes� no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building W One family ❑Addition ❑Two or more family ❑ Industrial Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other Saptr `Cl well o Flootlpt In ❑Wetlands: ;- ❑ Watorshed District Retrofit insulation in attic, air sealing Identification Please'Type or Print Clearly) OWNER: Name: Amy Harley Phone: (976) 766-9152 Address: 360 Winter St, North Andover, MA 01845 COLT CTbA° N6me: David Pall (Caddy Cir ° htry) l�h®na4 (617} 775®0113 d s Pi rr pont'R , Newton, M 02462 upruisr' Cdritrtdttiun Liderlse Exp: ate: ®7/27/20 7 0067 99 Homempr�vnn� ticeri exp. ®ate: 14379 00/03/201 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.EULDING PERMIT:$12.00 PER$1000.00 of THE TOTAL ESTIMATED CST BASED old$925.00 PER S.F. Total Project Cost: � 3752.66 FEE: �� Check No.: aReceipt No.: NOTE: Persons contracting with unregistered contractors ado not have access to the guarantyfund Signature of Agent/ wner . Signature of contractor F IA®RTH Andover Town of ® T 201,b r 1 �° / . s 1 Ver9 �.SS, *-- h ti COC MIC N@WICK V RATED AB��.�S �$ U BOARD OF HEALTH Food/Kitchen TPERSeptic System ••• BUILDING INSPECTOR 4 ..... ......�................... THIS CERTIFIES THAT . ••' Foundation ...la....... ..... .. .. .......... has permission to erect .........................® buildings o ••••••••• "'•""" Rough w ,,, Chimney to be occupied as ...... .. . ..... 1............................. Final provided that the person accepting this permi all in every respect relating to the InspectionhAlterrationl and p the ons PLUMBING INSPECTOR on file in this office, and soln the Town f North Andover.and By Construction of BuildingRough VIOLATION of the Zoning or Building Regulations Voids this Permit, Final MONTHS ELECTRICAL INSPECTOR PERMIT EXPIRES IN 6 Rough LES CONSTRUCT ON STARTS Service ••••.•,.•••.•• .......• .... . .. .. ...... Final ................ BUILDING INSPECTOR GAS INSPECTOR � ccUp CV pV Permit Required to ccuBuilding Rough Final Display in a Conspicuous lace on the Premises — Do Not Remove FIRE DEPARTMENT No Lathing or Dry Wall To Be Done r. Burner Until Inspected and Approved b the Building Inspect Street No. Smoke Det. CONTRACTOR WORK ORDER CLEAResult Printed: 4/21/2016 50 Washington St.Suite 3000 Work Order Id: S82240P08622C307 Westborough,MA 01581 Contactor Information Customer/Site Details Amy Harley Email:AMYHARLEY22@YAHOO.COM Caddis Insulation Phone(Eve): 978-766-9152 53 Pierrepont Rd 360 Winter St Phone(Day): 978-766-9152 Me�vton, 02462 North Andover, 01845-1409 Site ID: 500050182240 Total installed Measures' Quantity Unit$ Total$ Location Description1 $260.23 $260.23 Living Space Attic Stair Cover Thermal Barrier with carpentry 3 $23.18 $69.54 Door Sweep 3 $27.59 $82.77 Exterior Door Weather Stripping 10 $84.32 $843.20 Living Space Perform Air Sealing at Estimated 62.5 CFM50 140 $3.83 $536.20 Attic Propavent 2'or 4' 1,164 $1.47 $1,711.08 Living Space Attic Floor Open Blow Cellulose 6" 114 $2.19 $249.66 Damming Installed Measures Total $3,752.68 WorkOrder Motes Payments Incentive Payments $1,255.74 Air Sealing incentive $1,872.70 Weatherization Incentive _ Total Incentive Payments $3,128.44 Customer Share $624.24 Total Customer Share Less Deposit Of $208.08 Customer Share Balance(Due Contractor) $416.16 For questions regarding assigned work: Contractorinbox@CLEAResult.com. For questions while performing work: 855-821-2205. Permit Authorization e mass Form Site I®: 50182240 Customer: AmyFlarley i, Amey Harley ,owner of the property located at: (owner's Name,Printed) 360 Winter st North Andover (Property Street Addres) (city) hereby authorize the Mass Save Home Enemy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. (,,L4\�� Owner's Si u : ®ate: YA/ i, 0 FOR CLEAResult OFFICE USE ONLY CLEAResuit has assigned the following Mass Save Home Energy Services participating Contractor to the above referenced project: Participating contractor ®ate CLFAResult + 58 Wasirfn�toer Street,Suite 3000 ® Westborough,MA O1581 ® 1 7472 ),® Far mice Use On y Rev.102025 RCS PLAHVIEW DIAGRAM Customer: �'t°• Home Phone: � _ Address' 6 1��'�-�' Work Phone: ( )- Town: Any limitetiorrs far aceess by targe croak? No Yet If yes,desefiba: Any spedfic dimc[ions or landmarks? No Yes If yes.describe: site ID:SPIWDL;L Energy Specialist: 1®I�� ! Reviewed by: ` 1 ®® V- oors w `4 ot r..t ' 3JIM V (A-N RY I CA .5 to 4 , For Office Use Only Bushes Ladder Neighbor Proximity Pocket Doors Insert Radiators Fence(s) Existing Conditions X=Access ®=.Vents Note Inside Square R=Roof S=Soffit G=Gable RV=Ridge Vent CS m Continuous Soffit COE=Continuous Drip Edge T=Triangle Install O=New Access Note in Circle C=Ceiling W=Wall S=Sheathing Temp Unless Noted Otherwise ®=Vents Note in Triangle R=B"Roof S=Soffit G=Gable M=12"Mushroom For Access 2200-10-1/15 m • CONTRACTFOR pRODUCTS I SERVICE WORK COnser ation from your local utility Services Group This service is brought to you through support This Agreement is made by and among and Conservation Services Group(CSG) Amy ilarley Attn:RCS 360 Winter St 50 Washington Street,Suite 3000 North Andover,MA 01845-1409 Westborough,MA 01581 Site ID:SOOOS018220 Reg. No. 173484 project ID:p00050208622 Federal ID No.222457170 Custorner TD:C00050183648 (Mail completed contract to address above) Contract ID:20160330 ASEAL 1. DESCRIPTION OF WORK TO RE PERFORMED work on these"Premises"in a professional manner and in accordance with the terms of Contractor will perform or cause to be performed the following Una work inn detail(the"Work")which are incorporated herein by reference. this Contract,including the attached recommendationstwork order describing Location SM 20 Desimption 10 X80.23 Paifornt Air at rnetetl 62.5 CFFM Per Hour 1, Attic Stair Cover Thermal Ba�et with WA W2882.54 � .77 Door3 !LA $1,265.74 Exterior DoorW g Sub Tout: Utility lnc@ngvo Sham $1,255.74 Cust~CotntrttutU®n $040 Prt i0 Papa 1'®f 2 . r For office use only IL _ as a Deposit 11. PAYMENT n St.,Ste. /Nail check contract to CSG,ALlB►:6CS,t30 dap Customer agrees to pay Contractor for the Work,the Customer Share of the Contract ct sts). as f ch for the intra c tto be payable Et the Independent Installation payable to CSG upon signing the Contract(not to excI '• of rite total as a fls a)pay the Utility incentive Share of die 3000,Westborough,MA 01681.Final Payment S Changes to individual line items and/or previous incentives may increase or ttecrease the size of the Utility incentive Contractor("LLC")upon satisfac o c m letion of the Work.Customer understands that he/she will not be reg to paY Contract price in the amount of$ Share 111.DISPUTE RESOLUTION the IIC may submit atdt dispute to a private airbitrutlon Mie QC and Customer hereby muttmlly agree in advance that in the event Utas the IIC has a dispute Customer ng this regbedOnawl,to submit to such arbitration as provided in M.G.Q.c L42A. service which has treert approved by the Orrice of Conswnce Affairs and BttsL>�Regi dation mid tttsteotcr shall be tequiretl at a place other than an address of the seller, provided You may cancel this agreement if it has been signed by a party ram sent or by delivery, not later than midnight of the third you notify the seller in writing by ordinary mail posted,by g bu iness day follow ng the signing of this a reement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. �� nto o, (OR) initial7hm If Date In nate o r acted!IC here, applicable the Program to assign a Cus ® b Participating Contractor Da Name of CSG Rep entad a rimed) G gna 22�B-Ul6 ITIONS ON *Z' GCONTRACT FOR C®nser ati®n PRODUCTS SERVICE WORK Services Group This service is brought to you through support from your local utility This Agreement is made by and among and Array Harley Conservation Set-vices Group(CSG) 360 Winter St Attn:RCS North Andover,ARA 01845.1409 50 Washington Street,Suite 3000 Site ID:SO00501S2240 Westborough,MA 01551 Project ID:P00050208622 Reg.No. 173484 Customer ID:C00050183648 Federal ID No.222457170 Contract ID:20160330 WORK (Mail completed contract to address above) I. DESCRIPTION OF!WORK TO BE PERFORMED Contractor will perform or cause to be perforated the following work on these"Premises"in a professional manner and in accordance with the terms of this Contract,Including the attached recortunendadons/work order describing the work in detail(the"Work")which are Incorporated herein by reference^ Do"riptlon Quardity Location Attic Floor Open Blow Cellulose 8" 1,184 Uvlm $1,711.08 Dam 114 _ N/A $249. P rat 2'or W. 140 Attic $538.20 Sub Total: $2,498.94 Utility Ificentive Share $1,872.70 Customer Co $824.24 For office use only . Printed: 8 Page 2 of 2 IL PAYMENT + Customer,agrees to pay Contractor for the%Vork,the Customer Share of the Contract.Price as follows:Payment 91:$ as a Deposlt . payable to CSG upon p1ping.the Contrnet(not to exceed us or the total retail costs).BW check.&cont met to CSG,Attn:RCS,50 Washington$t,Ste. 3000,Westbomugh,INA 01581,Elinal Payment:S 6 as the final payment for the%York shall be Dayable to the Independent Installation Contractor("IIC")upon satisact com letiorl of the Work.Customer understands that he/she will not be required to pay the Utility Incentive Share of the 'Contract price in the amount of$.W .Changes to individual line items and/or previous incentives may increase or decrease the size of the Utility Incentive Share. Ill.DISPUTE RESOLUTION 'Ihe aC and Otaoumer hereby mutually agree in advance that in the event that the RC has a dispute concerning this Contract,the RC may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and Customer shall be requited to submit to such arbitration as provided in M.G.I.c 142A You may cancel this agreement if it has been signed by a party at a place other than an address of the seller, provided you notify the seller in writing by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third b tress da fol owing the signing of this agreement, DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Cus m Si lure D e ! Indi�ate youf'selecteo 11C hem if applicable (OR) Initial here if you want b �Q r the Program to assign a re Da Name of CSG Representative(Printed} Participating Contractor TERMS AND COMMONS APPEAR ON TFIX REVERSE. 2200-2-1/15 CIX The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Suite 100 UV Boston,MA 02114-2017 wlUw.mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricions/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibiy Name(BusineWOrganization/Individual): Caddis Carpentry, Inc. Ada ess: 53 Rierrepont Rd City/State/Zip: Newton, MA 02462 Phone#: (617) 775-0113 Are you an employer?Check the appropriate box: Type of project(required): 10 1 am a employer with 8 employees(full and/or part-time).* 7. New construction 2.®I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.0 I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Dem0litiOri 10®Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11. Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.L]1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub-contractors have employees and have workers'comp,insurance. 6. We are a corporation and its officers have exercised their right of exemption per MGL o. 14.0 Other retrofit insulation 152,§1(4).and we have no employeos.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also ffit out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. i I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Applied Underwriters Policy#or Self-ins.Lic.#: 468941190102 Expiration Date: 08/24/2016 Job Site Address: 360 Winter St city/state/zip:North Andover/MA/01845 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DTA.for insurance coverage verification. I do hereby certify under thepains and penalties ofperjury that the information provided above is trite and correct, Signature �� Date: 06/01/2016 Phone#• (617) 775-0113 Offleial use only. Do not sprite in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle ane): ; 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: CADDIN -01 MHEBERT DATE(MMOD"V) CERTIFICATE LIABILITY INSURANCE 1011312015 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(les)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 NAME: Mason son Insurance Agency,Inc. PHONE t;( 7S1)447.5531 Arc Ne:(701)447-7230 458 South Ave. Whitman,MA 02382 ADDRIESS:info@masonandmasoninsurance.com INSURERS AFFORDING COVERAGE NAIL# INSURER A:Colony Insurance Company INSURED INSURERIB:Safety Insurance Company 30454 Caddis Carpentry,Inc. INSURER C:Continental Indemnity Company 20250 53 Peirrepont Rd INSURER D: Newton,MA 02462 INSURER E: 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LTR INSD POLICY NUMBER IYYYY MMfOD/YYW LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE ®OCCUR 103GL0004936.01 08101/2015 0810112016 PREMIDA A13SES-ToEa occurrence) $ 100,00 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY❑PRO-- [—]JECT LOC PRODUCTS-COMPrOPAGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINEDSI GLE LIMIT $ 1,000,000 Ea acddenenlL B ANY AUTO CO29411 0710712015 07/07/2016 BODILY INJURY(Per person) $ ALLOWNED X X SCHEDULED BODILY INJURY(Per aoddent) $ AUTOS AUTOS $ NON-OWNED Per accident) Y DAMAGE HIREDAUTOS X AUTOS UMBRELLA LIAR IX OCCUR EACH OCCURRENCE $ 1,000,00 A X EXCESS LIAR CLAIMS-MADE X$170154 0810112015 0810112016 AGGREGATE $ DED I X I RETENTION$ 10,000 aggregate $ 1,000,00 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ER C ANY PROPRIETORIPARTNER7ECECUTIVE Yr N 468941190102 08/2412015 08124/2016 E.L.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? N r A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yeS,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 oESCRIPTION OP OPERATIONS/LOCATIONS/VEHICLES(ACORD 141,Additional Remarks Schedule,may be attached If mos®space M re4Wred) CERTIFI TE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE -- -- THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN f ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 019882014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Massachusetts DeparTment of Pub(Ec Safety Board of Building Regu ations and Standards License: CS-087999 non .'uj -1 DAVID J PRELL 53 PIERREPORT RD NEWTON MA 02462 Commissioner07/27/2017 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only -HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return Registration: 143789 to: Expiration: 8/3!2016 Type: Office of Consumer Affairs and Business Regulation DBA 10 Park Plaza-Suite 5170 CADDIS CARPENTRY Boston, 02116 DAVID PRELL 53 PIERREPORT RD. NEWTON,MA 02462 Undersecretary Not valid without signature Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 36,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit:WWW.MASS.GOV/DPS