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HomeMy WebLinkAboutBuilding Permit # 7/22/2016 I ` NORT�y BUILDING PERMIT o`�PL ,6a4 TOWN OF NORTH ANDOVER ._ - ::.... APPLICATION FOR PLAN EXAMINATION Permit NoM Date Received r, lS+pp•ITED hPR��S ©ate Issued: V TM ORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER` Print 100 Year Structure -yes. no MAP ( PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial Repair, replacement - ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other - , :;- :. Uri �. ✓ic�.. ,, a'A .:Y ..:.T,.;..-F F, i.:.r ,�.�..r.fir :vc,.rxs ,ptel� ¢ n � 1=�b'did 161 16 N91, S r , ",ted .:m.., ,., �f a ''. '. a p m ..� a "� zr'rw✓,. zF,y.,,.,�.,-G r� ���.^ikcv w ';, .., DESCRIPTION OF WORK TO BE PERFORMED: 11� �t V a oCcLf- oBr ar • i Adow as ar Identification- Please Type or Print Clearly OWNER: Name: Ri p,-rd M.iti4-< Phone: Address: SIS Su k No v L40.(Ni Contractor Name: µick. Phone: 2081 Email: t+n Address Po Supervisor'S Construction License: CS5Lto603s __-__Exp. Date- 91',71201 Ir Home Improvement License: 18Z797- Exp. Date: ? Z 7 201 ARCH ITECTIENGINEER t 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- $ Z 1 G G . gG FEE: $ —` Check No.: s 1 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund �. ._ . f t%ORYAy own o r: Andover -,ill l� No. - - h ver, Mass O �w.ct q coc"Icne WIcK r U BOARD OF HEALTH Food/Kitchen PER LD Septic System THIS CERTIFIES THAT ........................... ..... .... ......... .,..................,........., ........ BUILDING INSPECTOR has permission to erect .... . ... buildin s on Foundation ` Rough to be occupied as . .. . !�. �. ,��'.�. .�... .. ..... . . ..�. .,?.. ... Chimney provided that the person accepting this p�tit shall In every respect conform to the er s of the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspectio�{9lteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TION. Rough Service .. .............. .... Final BUILDING I ECT R GAS INSPECTOR Occupancy Permit aqurge,d to Occupy Budding 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 FederallD#064 M?.9 1� RISE Engi arilag MA � RrRee$la�ttois No 126NO RISEA division of Thletsch Engineering ENGINEERING 60 Shawmut Unit02,Canton,MA 02021 CONTRACT 339-502-6M FAX 339502.6345 Pago 1 PROGRAM CMA-HES 9 tM ATMCUMG�MFOR RISE ouscamaoBum a►stauers vtonM nage rxwxrr wsutxafunnt Richard Midler (978)689-8848 01/2112016 429709 00004 313 Surntmer Street 313 Summer Street 8MVM car.WMTB.MP etWNe CMY,8TAT%=P G.(y l i North Andover,MA 01$45 North Andover,MA 01845!, U S JOS DESCRt"10N HEALTH&SAM—7Y.Weatheriration work ca ttotprocecd until the spillage or oombustivn goers s fixed. $Q.OQ MR SEAL NG:Provide labor and materials to seal areas oryour home against wastelirl,excess air leakage. This work will be perrarmed in concert with the use of special tools and disposdo tests to assure that your home will be lett with a heaithtol Icvat or air exchange and indoor alr quality.Matoriah to be used to seal your homecan an include caulks,/boos and other products. Primary U=for sealing include air leakage to attIM basements,attached garages and other unheated arm(windows are not generally addressed.) This will require(8)working hours.A reduction in cubic feet per minute(dirt)ofair Infrllrarfon will occur,but the actual number of ofi n is not guaranteed. At the completion of the weatttcri-mtion work,and at no additlonal cost to the homeowner,a final blower door and/or combustion Wary analysis will he conducted by lite sub-contractor to ensure the safety of the indoor air quality. $680.00 OVERHAN0.Provide labor and materials to install l0"R-37 densely packed Class 1 Cellulase insulation to(76)square tbct of exterior overhang lecated below a heated floor area,by drilling hales in the overharwg from below. Holes drilled will be plugged. Plugs will be sealed with exterior grade spackle and left In a relatively smooth condition.Finish sanding and touchup priming/palnring will be the oustome's raponsibility. $304.00 GARAGE CEILING:Pr ivida laborand materials to install l0"K-35 densely padW Class i Cellulose insulation to 528 square rest of geragecc iiing located below n hoofed fiaararea,by drlliing hales In the call Ing front below. !doles drilled will ba plugged Plugs will ba sparkled and telt in a relatively smooth condition.Finish sanding and touch-up priming/paintingwvill be the customer's responsibility. $1,892.9& RISE Engineering will apply all applicable,eligible Incentives to this contract. You will only tic billed the Net amount. Currently, for eligible measures,Columbia Oas offcis 75%incentive,slat to exceed$2,000 per calendar year,and an incentive of 100%for the Air Sealing measures up to the first$680 and an additional$340 If savings ere jusdrmd by the auditor. For the safety and health of your homes Indoor air quality,we will be conducting a blower door diagnostic of tho available air flow in your home both bofom the work is began,and after the weatherizAlon work is complete.We will also conduct a full assessment of the combustion sarety of your heating system and water heater.This has a value of$90 and Is at no cost to you. Total allowable weatharization Incentive Is 53,110. $90.00 q Federal IDS 06-04M29 RISE Engineering ftl MA co R�ai n u°on No 190970 RISEAdivislanofThlelseh Engla¢ering ENGINEERING 69ShamanrUnit#2,Canton,MA02021 CONTRACT 334-502•034 FAX 339 9024945 Page 2 PROGRAM CMA-HES =Sowar Kur6SIN=1=1=111i r�ewx�s6etnw CIL4iaFAHt ....... ORM. DATE CI.tMN MUFKRRM Richard Miller (978)689-8848 01/21/2016 429709 OOD04 sawn erx�r _ 6MiFMa sTR aT 313 Summer Street 313 Summar Street ssrt==TY.srArs.xea•r,—_w. ast M env,aTAMM. North Andover,MA 01845 North Andover,MA 01845 .)OB DBSCRH TION Total: $2,166.96 Program Incentive: $1,817.72 Customer Total: $349.24 WEAGIERHLRMTCTFURNISHSE =ES•Ctf KRTEINAMRGANCEwrmAwnSF tFICAMON&FGRTHESUMGF "*Three Hundred Forty-Nine&24MOD Dollars $349.24 UPON FO MI.iNSpMONANDAPAROYAL6YmseNswaawaCUMTndl947RAaM8M6TORE=ALMUWDWNFU1J—W*MtUF1%VdU%GC"AWMDO MTS.YaNANY UNMMBALMNAFTEE00RAY6.6®EhlUNFOR WCETAIITiNR1"PONON aUARARTMig.FtlOKMQF-M=W;SMZQULMAMOOMAC=kE=MlTCK oo NOT SIGN THIS COUMCTtF THERE ANY SPAC- AunIG sr— Tune-Erse a Atct:PTA�cM _ naT�tH48 ixiemwat eeAY aE vmHmus�aY u9 tp NA7�GIIMtiYlITHR! Tl11TMaFMscHYFAHe1i ACCFMAKGe GF4fNi4RAQT-THeAaaYB PAtcSa,bP1dF1GATiGNB ANa COlt�TlaHeAHL' 311 aAYe BATl6 MAV TOW APAli8n£RSAY=WTWYWAREAfitnaflM 7000TEMWOM Af 6P6GtFtl'A6 PAYMANTYMLLSS MMDEAS OUiL6iP.a ADQVE RISE60 Shawmut Road,Unit 21 Canton,MA 020211339-502-6336 ENGINEERING7 www.R)$Eengineering.com OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at: c.7 , (Property Address) tj 14 do U t;r f P077 cl - lS (Property Address) hereby authorize k u CW2r4 A , (Subcontracto 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, eC Owner's ignature ,� Zoo Date NO Me .'odmamnonwe(ifth qbWassuchte'SPxUi mrd'Industried Acdd£:nii,' f i v 'Workers, Ctaaaw,aa;t'arxiaati£ara irtt;a'rrsuiwe ffidsv'it'.Getreraal ttra"taarc ens. 0 BE @t'ttADWIT11 THE pf;Rmt'rrt,"^G A'&e"t"tto ,yn', astt �f i It inc., JC.t tattir.a'tic�re �Itjje:Mill City Filerg y 4 cicit'ry :PO Bax 6411 C.ityl €tttt;/ i a:�fV rt(I eller, NH 03108 11 603 1_91-7923 Are.tnu nn eng40roe r a� heck the apprtapraate box: Onfiness t. pe(vertu red): 1. ✓,� R arra a en'aplclyrr wly 1 ...__-_-..._enjA y ces(Cull and/ 5. L Retail car Pa tAnrc).�' 6, 1,ttalaliShnaent ani a scab°praparicaw or partncolaip and have no 7. Of"fic6,a and/or :;ales(incl.real estate,auto,(titc.) 011113krycct,Nvotkingy 1,61.111c ire ally capacity. rivlar workers wrap.insurance rquircd] ua r corprrratfun Ind A raltie.am la a Mere wcl 9. �.. t:ntwrttainmcrnt tlleair right orexemp'atiaru per ca 152. y`;10),and we have I f7.� � MwnWheturing ncr cuaprlcay0 s, [No workers,e.arrnpr. insurance required-I�%'r' IC � I10"hh Cara i [. < l We my a near pr<>M"as,"nniralm,st,alAd fay vuluer mc :", 1 �� ! inSUrancc rc.ty.{ ._.otile°r ,MA'ZU�fI ) avrtir nra aarrt alr.rr;cc°�. l dca veurllcry �aaarn a. � `� �Q, .'. ',�1iay rtlttticaarrt rk�rt cVrer:I, 11cr,a�t 8 uru.,t,rtss+r"itp brut thr�s6vt�r:rrr ba�lo6 Showing Owir 1cc1rP a"," <irnpi�n atri6lrM t]a11r<t irrforert ltacar. _ ___.___.__._ cfl potal`oilic.erw hmc Owlylj led 111c'r17sch,cs,bm Ow 0611"pot','16oY rSwodwr clirtb}cc;.,.A l',`lll t.t"1°, 4f)Gd5t7L°175Gtr14'1f1 policy N rtxam c61 awl!;.ich N1'4 ur,r srrizadiaar should chick box 00. M((Car(rar€.(rrprl£r)wr the d rw)arrrrr(£i((zf;workers,(drtP(iwils(Cddarrr i(r.^,arr(rrdtrct. err ease'a era rl(r�2r^s. rsd£raa"(,w Pta�� rrrf®ray arrfiar°aa�rrm6£�er, fnsrrr<rnt.r.,a(�"srraaptan,y 1�larrrrc:C lratl< Irr�ttr;arrca� 1,r'tsaraa°r'a ciclress:One">undical A,vwue f SIS 30N t"ittf tartc,'lip: l` �atrcB7c tr t NH 03,101 l.tttt�actrfaaa�"at�q paarf�atlr icc ja�u VC7 189 . .._ .. —_ d;xpair.uti m Date 4I�rJ 227 l s span amszatta'aru prrRlc ^a1a.aR<aa<ttaaart g�tal c (sRucaa'wmnfm¢Rea; poky nuinnd a xpea•ealaamrt cRaate). Failure tsa Secure coverage aw required under S..a,tian 252 of,1 RCii,aa. 152 can lead to tlra:imposition cal criminal penalties of a lirrrc III)to :$1, 00,00 1110/or61na yQZu.imprisonoar-nt,as well as civil pwnikivc ,in the fla'rn ut r STOP WORK 'Ind a 'fine: rr1' up tcr$250.00 a day agd,Vire;vOlalur. Be,"aekised Hot "a a.capy of Vis stmeniew may bu l-orw ard.cl tel Ow Office°or lave tisrttrcrras(d'the 1t1A ttrr Nswerucc cr>vcmarc ticrifrmtrrua . ::.�'do hereby C£'b"dP, 4ra YBP. .' �Y,PP°� XArd,4 (file £P)&''P 7664";q1,I)°Pug that the dP1,�P10Fd(atiou tire,"Pidee' ,£(pl�o rC 1.5 dire and£."l r d cl. (.IjA£'iPdi jes( £lk8�1. Do not write hi this areef,to be d't)w1dC,k"ed by ci(J+or mown gjfichlL (At:y or"f"aauvn: 1.5's"inlp Aut'Raerrky (rircRc.€1rre.): 1, R�tarar d U Iteaalth .il, Barealdinf;t�tepat¢rrraant ,i.,f.'ityl`t'own t.'9 rk A Licensing Rtcrt rd 5.Select en"s Office 6.t'Aher Contact Persarwa Phone d":------------ 11 rcrla�.ru"iwr=.q.al�idi46 i MILLCITY-1 AGOULD CERTIFICATE OF LIABILITY INSURANCE PATE E(MMf 016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDE=R.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). ACT PRODUCER License#AGR8150 NAAME: Clark Insurance PHONE FAX One sundial Ave Suite 302N A)c No.Ext).(603)622'855 _..- _ _._.___— (Arc,Hol:(603)622-2854 Manchester,NH 03102 ADMDRESS:agould@clarkinsurance.com INSURERIS)AFFORDING COVERAGE _ NAIc p _ INSURER A:Arbella Mutual Insurance Co 17000 INSURED INSURER a:AmGuard Ins co 43290 Mill City Energy INSURER C: 106 Joseph St _..,_...,...,. ----..._..,.-...... -- PO Box 6411 INSURER O 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 FORTH E 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 ��-�...---- --------.�...Ab[1T.&U6R __,__............._ POLICY EFF POLICY EXP ---.._._........._.._... LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYY MM100lYYYY LIMITS A� X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,004,000 AMq�TO-REN D CLAIMS-MADE OCCUR 8500065735 04!29!2016 04/29/2017 pREM[sEs_(Ea gccurrence $ 300,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000000 GENT AGGREGATF LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY E PECOT- LOC PRODUCTS-COMPIOP AGG $ 2,000,000 ....._....------- $ ---............_......,.,....._....._ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT {Eaaccldenl)-____ $ 1,000,1j00 A X ANY AUTO 1020050919 04129!2016 0412912017 1 BODILY INJURY(Per person) $ ALL OWNED —'SCHEDULED BODILY INJURY(Per aca ) tden � $ UTOS X_ AUTOS X NON--OWNED PROPERTYbAMXbt HIRED AUTOS AUTOS ..(Peractident) $ $ J( UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 --..... .._.....__— ---_..._........................__. A EXCESS LIAB CLAIMS-MARE 4fi00065736 0412912016 0412912017 AGGREGATE $ 1,000,000 DED- RETENTION$ 10,000 $ WORKERS COMPENSATION X IPER OH-1- AND EMPLOYERS'LIABILITYSTATUTE,,,,......_... ER IN B ANY PROPRIETORIPARTNER/EXECUTIVE Y�NIA MIWC791896 04129!2016 04/29/2017 E.L.EACH ACCIDENT $ 500,000 ERI OFFICMEMSER EXCLUDED? -------....._............. (Mandatary In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 UIf yyes,describe under — ---- — SCRIPTION OF OPERATIONS below E.L.DESEASE-POLICY LiM1T $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 10f,Addlllonal Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover MA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE OO 198888-2014 ACORD CORPORATION. All rights reserved. o ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I i Massachusetts Department of Public Safety Board of BUilcting Regulations and Standards License: CSSL-106035 MICHAEL JOY 106 JOSEPH STREET,,o%% MANCHESTER NH 0 ' Expiration: Cohimissioner 08/07/2018 'ri%x.:errrltCr�f MWIn f(�,,((+" �(�!>JQfrP/l/e<'7([ License oa'registration Valid for❑lafividul use aallly Ofhec of C.onarunc�r Affairs.h�t3usifuss I2cgulutioai £.i di '"�OOME IMPROVEMENT CONTRACTOR lrufore the expirafiwi d atcp. if found return to. dr 'Registration: ift2`7f72 Type: Office of Consumer Affairs narat business Regulation �d 10 ['.ark Plaza-suite 170 � i7 xp3lratlan: 7/27/2017 Id.0 Boston,MA 02116 M!LCC{TY ENERGY,LL(-,. u^,� MICHAEL. JOY 1O6 JOSEPH STREET � s 47347 y Cwais 'iloats�"CureMANCHESTER,Nk