HomeMy WebLinkAboutBuilding Permit # 8/9/2016 " a
BUILDING PERMIT '
TOWN OF NORTH ANDOVER
APPlJCAT IG N FOR PLAN EXAMINATION
Al
Permit NO Date Received
Date �ssueti� e)
IM. OR
71
�O N
CAT 0
P 0.P
R 1F.Y 0.1WN as 3
Fret
District.. J.
�ZQNINGO
h Sh vil 0
M J.
7F
ii.-TYPE C)F IMPROVEMEN USE
i New BuHding One famiN
Addition 7 Industl-lial
V�C, Of More fa,-rj�y
f
Meration No. of units:
XRepajr, replacei-nent Assessory Bldg Others,
Other
Dem.ofition
Watiatidt
..ep
77
t W. vsbwern
OkAjINER: Narne� 96�,_OLM
address� qg Woo
A:; ... .....
CONT-RACTOR. N
Address'.
S00
Cr t' nt"... nsw D
ho IQ. e
Z:O::(.%
H.0.M "em nitticen.se'. ...
x1p:
.:M V e.
P
A
A.
ARICHITECTIENGINEEER— Phone-.
Address:_ Reg, Na
FEE-SCH5DULE:r3ULDING PERMIT.-$12.00 PER$1000,00 OF THE TOTAL ESTIMATED COST BASED ONS 125.00 P,'R,S,F".
1'offal Project Cost: S .. 157 i= E: S 4*7
Check No.: —Receipt No-�___I�
4-W110
NOTE: Pefsons cotitruc-Iiiig with iiw registered caffifiieftws do iwt Mire awceiis iff M mfl
signature of Ajentjowher
V%ORT1y '9
own of = � 6Andover
O �''� �` 0
� 7
�O LAKE h ver, Mass
WAS
COCM1C riE wICK yR-
�.� r�� Aea�,g5
U
BOARD OF HEALTH
Food/Kitchen
Septic System
6
THIS CERTIFIES THAT �+"
PERM , T
........ .. . ........ .......Z... . .... .. BUILDING INSPECTOR
has permission to erect ......, buildin s on . . . ..W .... , ,,,,, Foundation
......,. ....,. g � � Rough
So
4o
to be occupied as K.11T .. ..A. �.. . �t. ,! 11 Chimney
provided that the person accepting thi rmit shall in every respect conform to the terms e application Final
on file in this office, and to the provisions of the Codes and By-La s rela#ing to a inspec ' , Alteration and
Construction of Buildings in the Town of North Andover. C �� PLUMBING INSPECTOR
,[
VIOLATION of the Zoning or Building Regulations Voids this Permit. ■ Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
LESS CONS aA=B610ia�6wi
Rough
Service
... .. Final
N CT
GAS INSPECTOR
Occupancy .Kermit Required to Occupy Building Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
r
mks 0 .
FedoraI to 9 0"445629
RISE Engineering Rl Contractor Registration No 6186
MA Contractor Ragistmilon No 120979
Adirisiou of hielsclr Engineering CTConiraclorRngistraOonNa82012U
RISEl _ 60 S limsmul,Canton,NIA 02621ENGINEERCONT
p !l1�/"E4�'�Z
339-503-5197 rAX339-762-6345
Page 1
i'ROC;rL1M
IR EENFIM1a EtrnRSRonoa PORWHRBE
ChG'1-11L� EtmtrssRrRanxowEcastoi+>=Rrronwcaens
bEdCiUaEb BEIAN
cusTJER ANRFE DA1E "Wo WOM OWER
Willi:ltn Sahlas (781)820-5871 07/11/2016 436881 00002
nERviCE 114tEET 011-IJtto nWEET
43 Woodbridge Road 43 Woodbridge Road IE 0 V
UfNlcE CM.=lE,LP 111W110 cnv,rmle.nr 111
North Andover,MA 01845 Norlh AMover,MA 01845 jut
ni
JOB DESCRIPTION
ASE ONE- pose)for this calendar year.
50.06
AIR SCALING:provide labor and materials to seal areas ofyour home agrinst wasteful,cess air Ic-al age. This work will be pertormed in
concert with the use of special loots and diagmstic tests to asswo Ihat your home will he tell with a healthful level ofair e-whang!and
indoor air quality.M utcrials to he used to seal your home can inclodn caulks,foams and of Itcr products. primary areas for sealing include
air leakage to allies,basements,attached lis and other unheated areas(windows are not p:nemlly addressed.) This will require(12)
working hours.A reduction in cubic feet per minute(c(m)of air infiltration will occur,but the actual nunilw ofelm is not guatanteod.
At the completion of the wealiicrizution work,and at no additional cost to the humcowner,a final blower door and/or combustion safety
analysis will ho conducicd by tine sub-contractor to ensure the solely of the indoor air quality.
S 1,020.00
AIR SCALING ADDER: (6)workinghours,
$510.00
ATTIC FLAT:Provide labor and materials to install a 6"layer of R-21 Class I Cellulose added to(628)square feet of floored attic space.
51,1 17,84
ATTIC FLAT:Provide labor and materials to install a 9"layer of R-30 unlaced fiberdliss balls to(120)square feet ofattic space.
$2[')0.40
DAM M ING:Provide labor and materials to install a 12"layer of R-38 tmfaced fiberglass bolls to(314)squire fast for damming purposes.
$643.70
ATTIC FLAT:Provide labor and materials to install a 9"layer of R-32 Class I Cellidose sddod to(1592)square feet ufopan attic spam.
52,276.56
MTILATION:Provide labor and materials to install(3)insulated exhaust hose with roof mounled flapper vent to mihaust C�asling
bwIlrocnu fnn(s).
$356.23
vEN'rILATION;provide tabor and materials to install ventilation chutes in(12<t}ratter bays to nraintairr air Raw,
5248.60
INCENTIVE:RISE Engineering will apply all tipplienble,cligibly incentives to this contract. You will only be billed lite Net amount.
Currently,for cliLg'ble measure's,Columbia Gas offers an incentivcof 75°'x,not to cxi cod$2,000 per calendar year,and an incentive of 100°/u
for the Air Swung measures up to the first$680 and an Mclilional$340 ifsavin&+are justified by the auditor.
FOR A LIMITED TtNIE:Columbia Ga.will also offer an additionid 5to0 inceuive towards the weatherizalion work outlined in tills
proposal.This speciai Summer Incentive is available to homtawners who have had their Columbia Gas home energy'audit before July 31,
u
!3
t
Foderal to 9 06.0406629
RISE Engineering RI ContractorRoglstra0nn No 8186
MA Contractor Reglstratlon No 120979
e►ditislHn ntThiciscll Eng
RISE
inegering CTContractorReglstradon No 620120
' 60 Shawntut,CRntan,A1A4202t CONTRACT ENGINEERING C W NTR.A
339-502-51197 FAX 339-502-6345
Page 2
PROMAMl
ilio!CCHIRACTIS ENTERED W1DOE1W6EHRz9E
CNIMIt1S EMMUEEISNDANOTHE CUSTOMER rMWCRH AS
DeSCRIOW DEIOW
CUSWRL'R PHONE DACE CUENTO WORXMMER
William Sahlas (781)820-5871 07/11/2016 436881 00002
SERVICE 07MET DlWN0117MET
43 Woodbridge Road 43 Woodbridge Road
Semler.CnY.SU@,nP a4Wta CW,STATE.TTP
North Andover,MA 01845 North Andover,MA 01845
JOB DESCRIPTION
2016. A signed proposal for weatherizat ion needs to be submitted by August 8,2016 and work must be wmpteted by September 30,
2D16.
Car the safety and health of your home's indoor air quality,we will be conducting blower door diagnostic of I lie available Air flow in your
home both before the work is begun,and after the weathcrization work is Evmptcte,We will also conduct a full assessment of the
combustion safety of your bedingsy stem and water heater.This has avaluc of S90 and is at no cast to you. The muximutn oltowable
incentive for all mcasum,including air sealing is$3,210
The Permit will be secured by the insulation amtructor,at no additional cost.It is the homeOwlier's resPonsiblllty to Close Out this pcmit
by contact ing their municipality at Ilie eomplet ion ofthis work.
$90.00
JUL 3 2016
Total: $6,462.76
Program Incentive: $3,210.00
Customer Total, $3,252.75
WE AGREE HERCOYTO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECtFICATIONS,FOR THE SUM!OF
"Three Thousand Two Hundred Fifty-Two&751100 Dollars $3,252.76
UPDH FUI MPFCZCN AND APPRClA4DYM59 ENaREER1H0.CU MWHAonea AWr
REMTAUNTDUO IH n1l.1- leMSTOF 1%WIL.SS ML OEDrOTTl41.YORAHY
11NPAID CE AFIEA]9 DAYS.GEE REYER!IE FOR
DPCRnIHSiHRRW11i0t1 UH WARAIMEO.A1GiTS OFRECUKAOCHEDUUNA AND COMWIDR RECLSWICR.
DO NOT SIGN THIS CONTRACT IF THrzkE ARE ANY BLINK SPACES
C .&A
a oalalATu •4usE er9u�a+I� cuETrx+ERAcc a t�1/,Jt
"X:US CCNWACTEpY DE W WAAWH MY US IF14MEXECLMD wrmit nA'EOFACCEPUKU �� T
ACCEPtxNCECFcCIRRACT.vc SPn@9, DP Y.0}H:AI1D CCfDSftlCftS ARE
30 SAAr aPEW�160 FAYIXNTYNIi DE MIRE AS EclrlUNiO ADWE AU[HpitYED 1DDUIHEWQi1H
DAYS.
3'
i
f
Al
RISE60 Shawmut Road,Unit 2 1 Canton,MA 020211339-602-6336
ENGINEERING www.RISEengineadng.com
Efficiency Energized,
OWNER AUTHORIZATION FORM
William Sahlas
(Owner's Name)
owner of the property located at:
43 Woodbridge Road, North Andover, MA
(Property Address)
(Properly Address)
hereby authorize PILW �t
(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.
er's sffirk re
Date
� [Ed V E
3 2016
.x 71pe C,onimonwealth ea ' ttssachu epA&
Boslon, 114A 0211,t-201 7
r� t�t�rt�wtrtett,a��;per��/��t�
Workers,kers, f'<'rrarlrensation Insurance;Affidavit.General t3rasinest�cs.
,1"G t*EIINtt"CTING.,AUt`M1GAIXdITY,
Cott trtc.rJCt° ttttr.t�tticrl"l 'iattle:Mill City a truly
Ac3e.(tess:P.10-13-Ox Firl11
`ity/`',.ilttte/Z ip.Manr ,aiest r Nl l 03108 irltcar"le 1i trO3-3e31 /923
Areµycan an employer?("heck theappropriate Ito)c. t�aasr¢ress'W",yataca(awe<lartr ed); __
1.�._.._ fa.
I am�4�nalal�ye��'r with - <,rra)rl4tyccs('Fatal andf 5. � I Rctrail
✓ 17
of aaart tinge * Lstatrllshment
1 am a sole prelarietear or partnership and have no 7. ()lfyce.incl/or „ales(incl,realesuate,auto,ete.)
em loye,e s wrarlrnrl3 fiat nae inally capacity.
E4.
( writkerr' vornla.insuranccrrr.,clniredl
ltea _� lcarr-larcrit.
3.0 We are a corporation and its officers have,exercised c). F Etat rtainmcnt.
theh•r-iglatofexcarption per c. 152,§1(4),and we baave. I O.EJ Mail nt<tctrrrilig
asnalry [No workers'comp insurance rcelturcd aa
I].E]hlealticare,I• 4e are arrt rt3t
or gglair ataerta st ffe d by Volt If te r r a,
with no employees,[TIlo workers' comp. insilraracc,re,rl.] �t2j OtMae, —W
eluy I"Plic,trnt Owl chcvks box tti rnw4 iww~o fill owar die sectiml boltxc Muov inq rttrwic wMar4 ccwurt�en atwa�t lr4icy 41flotwlltort.
li'd w corprara tc,officers have C."mtptc'd tlrenlscolvest,taut Chiu corpt%iturn has taller cunployc es,ra workers cow pcarsntiorr poliw::y is requneal Caret smell art
araa<anintion should check box III
fain an cerrrgrlrayeWr that is Providing o'Or els'c°oara2rc re.settraorr insuraticefiv ng,r'raaphtives. 1ta>P+raar ra olae grrrlac tr rrl�e>rrtrsar7rora.
lnsnratnc ('ermlaany tsitaraac,:
Clark Insurance
Insurer's Addae t,:One Sundial Advent e S tlite 302N
(;i1yAs3ta+tcf7ila: Mlanclacaster, ll0,3't(72
111
f'crlicy ll ager �;cl�ins.l,tc, #flVfill(k!( 7;3`fde)fr. _._ _._ ..._. ____9 xlaicattieaaa l')atc+: 1l�cJ/21'J"1T __
Ailtach a copy ofthe waorker•r,'r.mraaataarawaataern policy decl,araat.i€arw Image(a�lolving,than policy raronha.a.rlud expiration elate).
Failure to secanres;coverageas required tinder Section 25A of'MG1.c;. 152 can lead to tilt;inrl�)Ositieart ofcrirninal Ire lMltics talar
fine tits to$1,50(Y.t)Cb and/or one-year inrlarisonraaent as well eras civil yresn elfic,s its the Coro)cw&"I'w*"t"OP"w1/ORK (7RHI`. and aw finer°
ol'up io$250,00 as day agairist the,violator. Be advised that as eotry of'this stzatement may be forwarded to tine Office eat"
lovestii„Cations of'the DIA for insurance coverage verification.
2 rfrr hereby e e r°Yi,,tar 1..� trrrs�rrrrrlgrcrrrraltae v gI'pejetry that that termor t nrrtionjortovidetr above rs trira,told crorrect,
nallir.4`._...... _ .......__,__.. .........
I'lacane U..603-:396-1620
t7jJI(gell rrse rortly> Orr no write fin this or'reo,to be completed gay vitt'tor^Crown t) avlrrl,
t City or Town;
Afarily
ircle
L Board ofHearltth(c2. Building l&eparturcut 3, ty/Town clerk d.Lic°ensinf Board w.Sar ect ren'ra OfF°CC
6.Other
I
Contact Per son: l*Gerona lh
MILLCITY-1 AGOULD
CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOJYYYY)
7/19/2016
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).
CONTACT
PRODUCER
License#AGR8150 NAME:
--..... .... ....._ ._. FAX .. ...—
Clark Insurance PHONE 603 622-2854
One Sundial Ave Suite 302N (arC No.EXt1:(603)622-2$55 ( )_„__
EMAIL a ould clarkinsurance.com
Manchester,NH 03102 ADf�REss: 9 � _.. _...._ ___._.
INSURER(S)AFFORDING COVERAGE NAIC N
_..-._. —
INSURER A:Arbella MutualInsurance CO 17000
INSURED INSURER_P:AmGuard_Ins Co .,...,., _.. _.._,., 43290
Mill City Energy -WSURERC:
106 Joseph St _
PO Box 6411 INSURERD,
Manchester,NH 03102 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 AbDL SUER _.... POLICY EFF POLECY EXP LIMITS
LTR I D WVD POLICY NUMBER MMIOO MMIDD
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
D ACaE TORE 4TEL�_
CLAIMS-MADE OCCUR 8500065735 0412912016 0412912017 PREMISES,(Ea occurrence} $ 500,000
MED EXP(Anyone person) $ 5,00_0
PERSONAL&ADV INJURY $ 1,000,000
i ..-. ---------
.-..,- --._...
V GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
PRO- 2,000 000
POLICY JECT LOC PRODUCTS-COMPlOPAGG $
OTHER: $
2 AUTOMOBILE LIABILITY (Ea accclidenntSINGLE LIMIT $ 1,000,000
p A X ANY AUTO 1020050919 0412912016 04/2912017 BODILY INJURY(Per person) $
V ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
' AUTOSXAUTOS
NOWOWNED PROPERTY DAMAGE $
o X HIRED AUTOS AUTOS _(Per accident)__.....,,. _
$
t
X UMBRELLA LIABX OCCUR EACH OCCURRENCE _. $ _...._1,000,000
A EXCESS LIAB GLAIMs-MADE 4600065736 0412912016 0412912017 AGGREGATE $ 1,000,000
i
DED X RETENTION$ 10,000 $
WORKERS COMPENSATION XJ SFATUTE OE
AND
AND EMPLOYERS'LIABILITY
B ANY PROPRIETORIPARTNEWEXECUTIVE —N IN
MIWC791896 04!2912016 4412,912017 E.L.EACH_.ACCIDENT — $ 500,000
OFFICERIMEMBER EXCLUDED?
500,000
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $
iF yyes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS below
i!
i'
3
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Town of North Andover MA ACCORDANCE WITH THE POLICY PROVISIONS.
1600 Osgood St.
North Andover,MA 01845
AUTHORIZED REPRESENTATIVE
O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CSSL-106035
Construction Supervisor Specialty
MICHAEL.JOY
106 JOSEPH STREET
MANCHESTER NH 0
$ILM2
h. :
Z7, CA— Expiration:
Commissioner 08/07/2018
0/ License or registration valid for individul use only
'y Office of C onsarncr Affairs&Rusifiess Regulation
before the expiration date. if found return to:
f`55� fmOME IMPROVEMENT CONTRACTOR
egistration: 1g27g2 Type: Office of Consumer Affairs and Business Regulation
10 Park Plaza-Suite 5170
e expiration: .712712017 LLC
Boston,MA 02116
MILL CfTY ENERGY, LLC,
MICHAEL JOY
106 JOSEPH STREET
MANCHESTER,NH 03102 Undersecretary N va r Yithout A <till.",