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HomeMy WebLinkAboutBuilding Permit # 9/13/2016 E tiOeoTk '9 BUILDING PERMIT ���"`� TOWN OF NORTH ANDOVER ; APPLICATION FOR PLAN EXAMINATION y �* >t Date Received Permit NC):� J�. �°A°^,w,° "Y �AnTeo `pp`~(y r3 4 RSSACHU`��� Date Issued: � 4 ` MPORTANT: A licant must com fete all items on this page Pry PRaPERT OWII Il ureen€ ea Px[cf I�It�P NO 1��4RCEL' � �OI��G G�tTRIC�I`` 1-ll�onoD�str�ct }ies �o llichtne appy , o 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 C Other Septic l Will Eloadltl e� I atrst lrstttt fiberglass insulation in basement Identification Please Type or Print Clearly) OWNER: Name: Maureen McKean Phone: 978-687-0931 Address: 22 Bay State Rd, North Andover, MA 01845 CITRAGTO ' Ntme.losertl ; ilrrarrtecC Valleulatto8 tIN � Rddl'eas A Sutilva lid 1iller�ESA 018 S UperVISG, ns:r Home lrnpr�me�rt Ltcart � 1��tlt� * ARCH ITECTIENGINEER 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: $ 1,020.75 FEE: $ Check No.: Receipt No.: r 'I NOTE: Persons contracting with unregistered contractors do not have access o th ranty fund St mature of AntlOur�ner see attached S nature of cr�tratr . 9 l - NoRr� q own-T aver of 0 No. ♦ y * h ver, Mass - ��� COC NIC EwKx V S U BOARD OF HEALTH Food/Kitchen Septic SystePER I m ■ Teo �t�� .........F. .. BUILDING INSPECTOR THIS CERTIFIES THAT ►...�r.................................... ............. .........., ......... .. , ...... ., Y Foundation has permission to ere ..................... buildings onC1. ..... ..... ... . �.,. ... ... p Rough ... . + .,... .. ............ to be occupied as ..... ,. anrt...• .• Chimney provided that the person accept this permit.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 PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover, Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS C®NS ;WO4 I® T Rough Service . ... .... ............. ... ................. Final BUILD NG INSPECTOR GAS INSPECTOR Occupanev Permit Required t® Occupy Buildin 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. Fedora II D 9 05-0405629 IMSE Engitiming RI Cont.-tor Registraflon No 6166 MAContractor RogIstration No 120979 A division ol"Illielsell Engineering RISECompany Address,City,NIA 1101100 ENGINEERING CONTRACT 401-123-1234 FAX 401-123-1234 Pago I PROORAM 11111 CaoRAC1"13 E141CIZED C IN I,X-I IF'S CROIRSERINGAND VIE CUMMIt POR WORK All DESCRIBED BELM C uslaw.R PHONE DAM CUENTO WORK ORDER Maureen Mckean (978)687-0931 07/00/2016 436853 M2 0EMCC STREET UILUNO STUET 22 Bay State Road 22 Bay State Road SeAvlog CITY,su'ta,zip 13111ING city,aimm,Zip Norlh Andover,NIA 01815 Noith Andover,MA 0IM5 ,1011 DESCRIPTION At R q-ALI NO:Provide IaIx)r and materials to sell,areas of your horse against%%umerul,excess air leakage. T Itis mrk I011 b. performed in conceit Ivith the Use of special took and dialptost to tests to assure that Your hollic will be loll with a licalth fill level of air exclumqp:wind in(k)or air qtol ity.'Materials it)IV used to Seal Your home can include caulks,mares anti other prodtkcts. Primary artnui liar waling include air Icilk-age to attics,Kiscinents,attached garages and Cather unheated areae;(kIind,,ml;ore not Imicrally. addrCSsIR.I.) T llis vvill,I'CtiLlire(4)vim king houis.A reduction in cubic sect per ruinute(cam)of air infiltration will occur,hit the act tyal nurinl:er ofctlm is riot guirantecd, At the completion ell'i lit;NNcatherizat ion work,and at no additional cost to the hoincomer,,I 1-mal No%ver door and/or conftsl ion safety analysis v01 k,,conducted by the sub-contractor it)casure thesalety or the indoor air ilimlity.10M RA 91', $340.00 ATTIC AC CIESS:Provide lahwand materials to insulate the IW,of(t)attic hatch I%ah 2'rigid"Fliernias:board.Wealherstrip the S60.00 BASINENT CEILING:llrovi&laJxIr and ninteriwis to instidi(109)linear feet ol'R-19 unforced fitnrghiss insulation to the perimeter of the bust meni coding at itic iious;c sill. S 190.75 INCENTIVE':R[S[-.Engineering will apply III]applicable,eligible incentives to till,,,contract. you Will only be billed the New airloulli. Currently,for eligible measures,Columbia(las offers on incentiveol'7511/0,now to exceed$2,000 per calendar year,and all incentive of 10(11,For the Air Scaling measures up to the first 5690 and an additional$3,10 irsaving-s are justified by the atdilor, MR A LIMITED TIME:Columbia Gas will also otter all additional 5100 incentive towards the outlined In this proposal.*[']its special Nolinier Incentive is available to Immeomers alto have had their Columbia Gras holne energy audit berore July 31,20111, A signed proposal for vvatherization needs-to IV,s0mitted 1)),AtoBtSt 8.2010 and work inuit IV completed by 1cptemlwr 30,21916. For illiesal'oty and licalth of your homes indoor air quality,vvc will IV cooductinija blower door diagnostic ol'the available air llovv in your Rollie Kith Inrore the NImk is lvtlun,and after the NvCathcrizatioll N%klrk is CMRI)ICIC.We will UK)C0odtlQ1 a fill assessment of the coinbmtkm safety ol'yotir licatingsystem and water licater.This llaq It valtk�ot'S90 and is it(rich CoM to you The Illaxillium allcmalile incentive for all measurei,includinV,air scaling,is 53,210 'Vile Permit will[V scoured by tile illsithilion contractor,at till liddilional,cost. It is the responsibility to Clime out till.,, Permit by contavaing their Intuticipillily at 1110 completion orthis work. 5110.00 V E JUL 2016 Federal ID 0 05-0405629 RISE Engineering RI Contractor RoglotratIon No 8186 1AAContractor Registration No 120979 A division of1bivisch Fmglnecring RISCompany Address,City,NIA 00000 ENGINEERING' CONTRACT 401-123-1234 FAX 401-123-11234 Page 2 PROGRAM "ARS,CaMACTIS ENTERED INIODE7WEEN RISE ENCONEERINCIAND DIE CUS"ER FORWORKAS MCFUREDBEL)OW CU?J10MR DAM CLIENTO WORKOROER Maureen Mckcan (978)6874)31 07/06Q016 4136853 00)2 SERVICE STREET BILLING STREET .. 22 Bay State Road 22 Bay State Road SERVICE cfwwMw,Zp S1wNo CITY,STATE.zP North Andover,MA 01815 North Andover,MA 01845 .JOB DESCR11TION Tota 1: $680.M6 Program Incentive: $718.06 Customer Tota 1: oma?4 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE W ITN ABOVE SPECIFICATHRIS.FOR THE SUM OF 0 .31 Dollars -07-.3 V UPON ANAL INSPECICNAND APPROJALSY RISC EINAOECRIHCL CV3'0&RACR5C3 1DflEA4TVXVHtDUS IN FULL IHIERESTOF I%WILLDECHARGE-I)MOILYONANY UNPAID BALANCE AFF_R 40 DAYS.SEE REVERSE FOR 14'PCRCNr"VCV=W1 Of CAJAItANSES,R101130FRECIWCN,SCHEDULING,ANO CG4MCTORREctsuATON. DONOT SIGN THIS CONTRACT IF THERE ARE ANY 13L SPACES 98104A,10kc Ime V Una CUSIUKC PTAH NOTE:UM 430011RACTMAY DEVVI'MORAWNDY US IF HUT EXCCUIBD VVIZINO DATE OF ACCEPIVICE ACCEPTANCE 0FCCNRACT-1HE ABOVE PJUtES,$PECIf1CA1a0H3 ANDC04=043 ARE 30 DAYS, SATSFACMOTY 7D US AND ARE HEREBY ACCEPTED.YOU ARE A"ICRIZEDIDDOHEWCRK AS SPECIFIED,PAYhVHTWU.0V MADE AB OMNED ABOVE j .......... .......... CASE it SIDING WS!CBI INY ALLUM f ASB I BRICK/ ROOF ARC,H)3-TAB! COLOR VENTS OATH FLAPPER lnip RIDGE ROOF x A- -GAB xLE _____ SIZES OK FOR WOR Mc Y/N SOFFIT: NONE/WOOD I ALUM< I Y DEPTH 10 COLOR L,'l//1 i?'eSTYLE �c?/ )9( __,. ... a t FLAT KNEEWALL WALLS D AIR SEALIIJG AADD VENTS EJSLOPE 0 KW FLOOR 0 KW SLOPE, O SILLS � O MAKE ACCESS ❑EXISTING ACCESS RISE60 Shawrnut Road, Unit 2 1 Canton, MA 020211339-502-6335 ENGINEERING` www.RISEengineering.com W. OWNER AUTHORIZATION FORM r C,G k2 C, X e- (Owner's Name) owner of the property located at: Property Address) /J?,L (Property Address) hereby authorize (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. Owner's Signature Date 2016 The Coxrimowvealth of Massachusetts Depar rnent of Industrial accidents Office of IMvestigeffons 600 Washington St. Boston,Imo. 02111 %yw,}.-.ass.govidia Work-ees Compensation insurance 4ffdai t: Iectridans/Plumbers Applicattioninforl=ration---Please Print Legibly Name(Business/Orgsr_;za�oafEndividual10 ner:k,- -, 2ikt'T�cl: Address: CD3 Ac�k t tlrfafJ f�'• Czt��/StaterrZi :�31(���lc �a Gifs+� - Phone T: i Are you an employer? _�,_re you the homeowner? Check the appropriate llu=nber: 1. 1 ani an employer with JS' employees(full and/or part--time. am a sole proprietor or partnership S:1€ave ao employees working for me in any capacity_ '• ;. ram a homeowner doin ill=cork m:'self ('N+o workers compensation insurance required.) i I am a acneral Contractor S:i have hired the sub-contractors!isLed on the attached sheet. (These contractors have-."orkers comp.insurance and T have-at~Lached a cony of their ins.) '4'4je ars a corporation and its officers have eyercised their right of exemption per MGL c.I0535' I (=1), and ire haie no employ=s. (No workers cornp.insurance required-) E F7 .Rr'aT7p1ECa[it'sitn�CiteCiiS iso/ I thus:alsff gil 3Et the section betow showing/hoer workers•comp.porky Enfib nation. ` z r±O:;enc-rFee_w'ua subinir l::ttt3 CifiEC:l'v ii in:itl:::lilt ulev ar=dainL-at.C?sort{C %t:_.._'uir8 viiitiv�-:un4iiiCr .:i:SC SuI'i:A'.t:;lgl. !1. affidavit indicating slide. ` contractors that check t[iis box must'.tffaci an additior.:tl sheet the u:mt!of the sub-contractors 2itd theirzcorkLrs- I Compensation poticp information_ T ape of project(required): CI€eck approprinfe E S. .ezv Coustruction +._Remodelinor 8__D'pmolifion 9- . Building addiilon — r-,- - 10. El,ectrif:.fd 11. Plumb, 1'. Roof 1a.��ibe�- iS�t(�tc;:.. I qni:En employer thrt is providiug workers'coal emation insumnec for my employees. Belnvr is fire nolict'C jab site it=fa ,Insurance eompan3-Name: Policy i or self-ins. Lie. ��� RANCE R® CERTIFICATE OF LIABILITY INSUDATE(MMrAAlYYYY}Vy 6/13/2016 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 he endorsed. If SUBROGATION IS WAIVED, subject to Me 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). ODUCER CONTACT NAME: tomatic Data Processing Insurance Agency,Inc PHONE —_._- FAX +DP Boulevard Arc No.Ext): Arc No): seland,NJ 07068 ADDRESS: INSURER($)AFFORDING COVERAGE NAIC# _ INSURERA:5Star V3 AAIC American Alternative Insuran IURED Merrimack Valley Insulation Corp INSURER B: _ 23a Sullivan Rd INSURER C: North Billerica, MA 01862 INSURER D: INSURER 5: INSURER F: )VERAGES 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. TYPE OF INSURANCE ASI SWVD,UER POLICY NUMBER HIM ICYlYEYFYFV FOLIC YYYPf W LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO-RENTED- PREMISES O ERDPREMISES(Ea occurrence $ CLAIMS-MADE M OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- LOC _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) _ $ ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE - AUTOS Per accident $ $ w, UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OT' AND EMPLOYERS'LIABILITY YIN X TORY LIMITS ER _ ANY PROPRIETORIPARTNERlEXECUTIVE V9WC749118 6/18/2016 611812017 E.L.EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? N 1 A _._ _,.... (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 If yyes,describe under - DESGRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,00 SCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it more space is required) ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. KORO 25(2010105) The ACORD name and logo are registered marks of ACORD l �t �' i.� '%+'ems.r� .�ul�G•i�• Off ce of CODSUrnerA#'sairs and.Business Regulation 10 Parr PIaz6-Suite 5170 -Boston;Massachusetts 02116 Horne!MP1-01,ernent Contractor,_-tejistration Registration: 180506 T119-- Corporation MERRMACK VALLEY INSULATION CORP Exptratian: 1//2412016 ;F0 26-5524 JOSEPH RYAN _ 23 A SULLIVAN RD BILLERICA, MA 011862 Update Address and return card.Mork reason for cbao;t :Address " Rcnexval rulploymcut Lost Card _-Office orCons umer_LCf,Rirs 3 tScsiness Re-u)ation License or re;,istrntion t-a)id for indiviciul use Only 'PME IMPROVEMENT C0N R.AcTQR before the expiration date If found return to: 180506 ";�^g)stration. -412aI Type: ofrceofCons Elmer AffairsandBusiness Reoulation �rlrl atian: 112t1207B corpor-r_tion to P.Irtc Plazo_suitU517Q MERRiITACK VALLEY W1,9ULATION,,GoRP Boston.MU 02376 JOSEPH RYAN 23 SULUVAPj RD BILLERICA,M 01852 i nticrsecretari r` :`+'iot'valid rlitgout sibnat:rrc �� :t"aS�.:;'.lUSG- v'- " :c:E:ii t... "zfi.�ii;:��'1>..w;•" _.ve tse.GS-075547 t 15 IM 200 MM-a ltiait Dr..?Apt 201 Lynnfield lt/1.k 00-40 _ c-mn SS,;i::c; 02/04/2017 A.,