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HomeMy WebLinkAboutBuilding Permit # 9/13/2016 saw rr� BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ; Permit NO: '0.1 Date Received �Qq o�,. •.,..y'" ' ��ssgcµus�s�y Date Issued: T ORTANT: Applicant must complete all items on this page LO T10 :fit llorth ,rtdo�, MA ti 14� Prat PRCPEIT C}�IER DelaraAr�lnott �rrr�t TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building N One family ❑Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ c777 Il�d 77 D et � rs� t cellulose insulation in attic Identification Please Type or Print Clearly) OWNER: Name: Debra Arillotta Phone: 978-777-8722 Address: 1532 Salem St North Andover, MA 41845 CONTRAL TO Isar e a �l lerr��cl<V II; lOsUfo porta + Addf`ei 2"3A �ulltart Rd I3rIleicaY I+IA t I I Slpr�tsdtYs CQttstttcttar �rct Hate Increrlat [oaa66Epp lata ARCH ITECTIENGINEER Phone: Address: I Reg. No. FEE SCHEDULE.SULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 3828.88 FEE: $_ Check No.: �'�. __ Receipt No.: 36,0 NOTE: Persons contracting with unregistered contractors do not have access the uaranty fund igrlature of Agntl0iwr�ete . tacedgr�ate ofCo ntrator 00RT� q Town of sndover Q No. 241 h ver, Mass t0[N�C o K E k, nE wecu .o0 �RTED A'F A1.0 s � BOARD OF HEALTH Food/Kitchen PERMIT LD Septic System • THIS CERTIFIES THAT . ... . �... , BUILDING INSPECTOR has permission to erect .............. buildings on .�, .., .em.., ,. ..,�`,_..... , Foundation . ..4 g Rou h to be occupied as ...............u.'. . .... +.�..........It A .0. IN....~... .......................... Chimney provided that the person accepting 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 Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONST TI® RT Rough Service .. ......... ............... ......... Final BUIL G INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy RuRough 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. Federal ID#05-0405629 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 R ISE A division orTldriseh EAigincerirtd, ENGINEERING' 610 Shownrut Unit N2,Canion,NIA 02021 3317-502-6335 FAX 339-502-6345 CONTRACT Page 2 I'ROGRAN1 TTIIS CONIPACT Is EnTHREO ROD BETWEEN RISE S} CNIA-111 ENOINECRINO HND TIIE CUSTOMER FOR WORK AS DESCRIBED BELOW CUSTOMER PHONE DATE CLRiNTP WORK ORDER Debra Arillotla (978)777-8722 12/14/2015 4119721 00003 SERVICE STREET' IIILA.INO STREET 1532 Salenif Street 1532 Salenl Street SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP North Andover,MA 0 18 45 North Andover, MA 018,15 3013 DESCR.IrriON VENTILATION:Provide labor and materials to install(1)insult fed exhaust hose with soffit mounied flapper vent to exhaust existing bathroom Fan(s). SIl8.7S VE I IIJ411)N:PrLTvlde labor and rmnerillls to iarstall+"catilruian chutes in(36)faller Trays to nuainitdn Lrir Ilow. $72.00 OVERT IANC:Provide labor and materials to install 10"R-37 densely parked Class I Cellulose insulation to(48)square feet of exterior overhang located below a heater!Door area,fly drilling holes in the overhang from below. I lobs drilled will lie plugger!. Plugs will be scaled with exterior grade spackle and loll in a relatively smooth condition.Finish sanding and touch-op priming/pahi ing will be the cuslolnr's responsibility. $192.011 RISE l ngincering will apply all applicable,eligible incentives to this contract. )oil will only be billed the Net anuunTt. Currently, f eligible Itacastlres,C'L,Ilurnbli Gas(!!lees 75%incentive,not to exceed 52,000 per cltirridar year,and an inrcruiNc or 100"/,for the Air Sealing nicasores up n tine first$680 and an addilional$340 if savings are,instilled 1Iy die auditor. For the safety and health of)-our(tome's indoor air quality,we will be Conducting n blower door diagnostic ofthe available air flow in your home both before the;work is begun,and alter the Nvoidwrimlion work is Complete.A11C will also conduct a lull assessment of the combustion safety oryour heating,System and Water leator.This has a value ofS90 and is at no coat to you. Tolad allowable weatherividion incentive is$3,1110, $90.00 r, < Total: $3,792.80 Program Incentive: $2,940.00 Customer Total: $952.90 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF *'Eight Hundred Fifty-Two&80/100 Dollars $852.00 UPON nuAL INSPECTION AND APPROVAL BY RISE EROINCERINO.CUSTOMER AOREES TO REMIT AMOUNT OUIi IN FULL..INTEREST OF IV44%ILL BE CHARGED NONTIILY ON AILY B9IPAID RALANCE AFTER 30 BAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON OUARANT'EES,fllOilTfil OF IIECISIOIJ,UCIIfiOLiLINO,AND CONTRACTOR REOISTRATIOII .. . DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPAC A in EI ON RE•RISE,C"g4 oltnp _.. CUSTOIAER ACCEPTANCE NOT•:THIS CONTRACT MAY BENlITIIOIIANJIJ DV US IF nor EXECUTED NliTtIIN DATE OF ACCEPTANGE ACCEPTANCE OF CON LAC THE AOOVE PRICES,SPECIFICATIONS AILD CONDITIONS ARE 30DAYS SATISFACTORY TO US AND ARE HEIUJIY ACCEPTED.YOU ARE AUTHORIZED TO OO Inc-VIORK AS UPECtriCO.PAYMENT VML BE MADE AS OUTUREO ABOVE i Federal 10 d 054106629 RISE Enginceiring RI Contractor Registration No 0186 MA Contractor Registration No 120979 RISE lt division ol"I'llicIsch I-1,11gineuring ENGINECRING 60 Slutwinot(Joh 112,Clinton,MA 02021 CONTRACT 339-502-6335 FAX 339-502-63,15 Page I PROGRAM 11 13 CCUFFRACT IS DITERED INTO ItEnVEEII RISE CNIA-IIES ENINCERING Alto TRC CUSTOMER Fort WORK AS DESCRIBED BELOW CUSTOMER PRONE DATE GLIEKT a WORK ORDER Debra Arillotta (978)777-8722 12/14/2015 419721 00003 SERVICE STREET DILILING STREET 1532 Salem Street 1532 Salem Street SERVICE CITY.STATE,ZIP UILLING CITYATAtC,ZJP North Andover, MA 01811.5' North Andover,MA 018415 .1013 DESCRIPTION 'IIIJAsiz miProposal fir this calendar year. S'0.00 HAZARD HARRIER:We have identified that llicre are recessed lights present ill your home,unicss the recessed lights orcccnified its IC-Tilled(Insulation Contact Rated)we%Vill create It 3"clearance space around tile fixture by Using fitherghiss blanket iniolatioll Its it dallialling material,no insulaflon will be instilled across,the it)[)and closed cavities which contain recessed lights will not lie,insulated, $0.00 BARRUIX We have discovered%vital appears to be a mold/mildew-like sobilance it)your home.This is being brought to your allentiort it)identify it:as it pre-existing coaditioll to file insulation and stir waling Nvork planned lbryour home,Your sigoulore is your acknowledgement of Iliesc conditions all(]agreenicia it)proceed. 50,00 AIR SEALING:provide labor Rod materials to seal areas of your home against wastefid,excess air lcalla,e, This work will be perrormed in Concert with file Use orspecial tools and diagnostic tests to wsture that your home will he tell with a healthful level of air exchange and indoor air quality.Materials to be used to seal your lionic Can include Caulks,Imulls told to prodtjcts, primary areas for scaling include air leakage to attics,basements,nuached garages and other unhealed area,;(window's-tire not generally addressed.) This will retlaire(8)working hours.A IrCrIaction ill cubic feet per minule(cfio)ofair infiltration will occior,bill the actual number ol'clin is not guaran teed, At the completion orthe weatherization work,and at fit)additional cost to flit:homeowner,It final blower door and/or combustion slilety analysis will be conducted by the sub contractor to ensure the safety ofthe indoor air quality, 56150.00 Alit SFIAI.INO ADDER: (2)working(ours, $170M AYFIC FLAT:provide labor and muterials it)install it 6"layer ol'R-21 Class I Cellulose added to(384)square feet of floored attic space. 5683.52 DAMMING:provide labor and materials to install it 12"layer of R%38 Unlaced fiberglim hath to(136)square feet for damming purfloses, $2780 M-11C FLAT:Provide labor and materials to Install at 10"layer ofR-35 Class,I Cellulose added to(864)square I ie Space. S1,270,08 STORA01'HARRIER:I lonaeowner is responsible flit tire removal of the stored items blocking the installation of weatherization work in tile attie. Removal must occur prior to the scheduled work-suitil. $0.fx) ATTIC ACCESS:Provide labor and materials to install(1) easily moved,insulating cover lbr tire nitic access kilding stuir. A small flat surface of ilb,wood will be created moond the opening within the attic. This will allow file cover's integral weather-stripping it) restrict air leakage. $237,65 CASE#_ � _� � � SILTING VVS/CBIN L ALUM rASE/BRICK/ ROOF RCFI 3-TAB/ COLOR / VENTS L3ATH FLAPPER x RIDGE ROOFS 1" GAELS x SIZES OK FOR WQRK /H SOFFIT: NONE/WOOD!ALUM I Y DEPTHCOLOR LrJ STYLE a 19 ,_�. ... LT -lHi ------ 1 K r dI _ J, ___ ___•._ ._ _. . ._.... . ........_ __..... ..� _ _._.. . _._. _____... _c...._ _.. FF ____1 , ;. . _.. . � ark, �!Z , rt � 71 m, rr 1 D FLAT l___..J I<NEEWALL D WALLS 0 AIR SEALING YYY AADD VENTS SLOPE 0 K FLOOR l_._....I KW SLOPE 0 SILLS � O MAKE ACCESS []EXISTING ACCESS OWNER AUTHORIZATION FORM (Owner's Name) , owner of the property located at f (Property Address) 5,` (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building i permit and to perform work on my property. Owner's Ignature s Date G I i t } s , The Commonwealth of Massachusetts Department of Industrial Aeciden.ts O.fi'rce of Investigations 600 Washing—ton 5t. Bostoa,TVU 021.11 Worker's Compensation insurance Aaffidavit: Builders/Contra.cfor's!Ei lectricians/Flu hers Application Information---Please Print.Legibly Name (Business!Organiz.itionlj-:ndividuai/0-vvner_4- 14 Ac.,C 17(,? Cde-hOO! C-el -10 Address_ Q a A c&:.-£b A tJ City/State/Zip: ll -cicA LAA Phone: i Are you aa gmployer? Axe you the homeowner? Check the appropriate number. 1. I am an employer with emplovees(full andior part-time. 3. I are a sale proprietor or partnership&Ira3•e no employes working for me in ant capacity. i 3. _ I am a horneoviner doing ail::York,self. (Ivo workers compensation insurance required.) 4- I am a general contractor S I have hired the sub-contractors listed on the attached sheet. (These contractor have workers comp.hisurance and I have airached a copy of their ins.) �. We are e corporation and its officers have e-xercised their right of exemption per MGL c.1.53y1 (4),and we have no employees. (moo workers comp.insurance required.) } Q any anpiiC lnE that checf s boss must afro hil 3u:the section comp.pokey inRormnation. ' . k� . ::7�.': -3 37TC�FYC:av� cl7:It L�i5.I1aa-vitindic.ztin_they are Aairi.Vi:tuz.rsd� I'dia i-mi f alfidavlt iadicahnry such. n Contractors that check this bot must A%,qch-an additional meet showingthe u me of tiee sub-conttractur5 and theirivorkars' l compensation policy information. 'l'ype o`project(required): Checic appropriate 6. e-iv C4TRKTUCtiGR 7. Remod-cling$. Demolition 9. Building a.r?d pori 10. Blectrici-d 11._Plumb. 12. Roof 13_ Other. T- i t -le.— � lam an Below is the police C job site info. Insurance company-Name: Polios 7 or self-ins.Lie.= Expiration.Date: _• Joh Site kddress: .attach a copy-of-worker's compensation policy declaration Mage(shoving tile.palky;camber and eipiration date. ?email{era«,secure coverage as required cruder Section 25A of N'dF':.c_ 152 can lead to the imposition of criminal pettaltiess ofa fine up to 51,500:00 armdrot•ane Year itnprisoamc�� ,;;s well as civil penalties in the Poem of a -TOP WORK ORDER and a tnL oFup to$250.00 a day-against the violation. Be advised that a cop,of this siaternent-inav he forwarded to the Office of Investigations of the DIA for insurance coverage verification. do hereby cert9 °under:,lie•pains at�d penalties 4f perjury that the infcrrnwuari pra'.ided above is true and correct. Official use only: Do not 46'bze in this a;.ea,to be completed by city or til--len.official. Cli" or T��>�,��: Permit. L•'a�4i �+� ! issuIfti•%authority (chock one) 11—Board oard oz Health ?-_Building Dept. 3=C-it_:fTosvn Cler, 4._—Electrical tush. 5._Plumb Ctrs o.—Other _ GonLact Person: (print) - -- _ Phone 4 ��J DATE CERTIFICATE OF LIABILITY' INSURANCE 02/24/2016 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). PRODUCER cOWAcT Carolyn A Coughlin Charles J Coughlin Insurance _ __� _.___----------------. PHONE (978)957-3588 14 Dinley Street E-MAIL aron cou tl P.O.BOX 10 ADDRESS: cl linins.com y @ � Dracut,INA 01626 _ [NSURERJSIAPFORDINGCOVERAGE NA1CH INSURERA: Northland Insurance Company 24015 INSURED Merrimack Valley Insulation Corporation Joseph A.Ryan,Jr. INSURER B; Safety Standard 39454 Sullivan Road INSURERC: Torus Specialty Insurancemp Coany A0159 N. Billerica,MA 01862 - - -....- _. - - INSURERD- � INSURER E: - INSURER F: ! COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 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. BR .. - -_____—__- LTR TYPE OF INSURANCE -_-... -..POUCY EFF -_._-_._._-------- i SD LNVU POLICY NUMBER MMfDDIYYYY)I(MNVDDNYM LIMITS A %/ COMMERCIAL GENERAL LIABILITY WS274182 01/21/2016 101/2112017 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES(Ea occurrance $ 900,000 MED FXP(Any one person) $ 5,000 —. _..-------------..____--_T PERSONALBADV INJURY § 9,000,000 GEN'LAGGREGATE LIMIT APPLIESPER; GENERAL AGGREGATE 5 2,004,000 �/ POLICY jECT F LOC I PRODUCTS-COMPIOPAGG $ Z,DI)O,ODO OTHER. 5 B AUTOMOBILELtABILITY 6205006 111255/2015 1112512016 i cOMBINEDSINGLE LIMIT Eaaccident) S 1,000,000 ---1 11 .__..._ ANY AUTO BOMLYINJURY(Per person) $ ALL OWNED SCHEDULED AUTOS V AUTOS BODILY INJURY(Per accdenq § / HIREDAUTOS /i NON'OWNEI? PROPERTY DAMAGE .�1. Y.J AUTOS LPeraccident)..___ i $ C V' UMBRELLAUAB �; OCCUR i j ;87593L161ALI 01/21/2016 01/21/2017 EACHOCC_U_RRENCE gµ_ - 1,000,000 EXCESS DA6 CLAIMS, DE AGGREGATE —_ $- 1.000,000 OEO , RETENTIONS 10,000 § - � D WORKERS COMPENSATION � ( / P✓R OTH- AND EMPLOYERS'LIABILITY YIN' � V STATIfrE ER ANY PROPRIErORfPARTNERI�GUTIVE E.L,EACH ACCIDENT-- $ 1,000,000 OFFICERWEMBEREXCLUDED? NIA ...-- (Mandatory in NH) E.L.DISEASE-EA EMPLOYE S 1,000,000 it Yes,describe under _..._ . ----_ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 1 DESCRIPTION OF OPERATIONS LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more apace is required) JOS DUTIES:Insulation Installation:Additional insured companies respectively are Action Inc.and National Grid USA,its direct and indirect parents, subsidiaries and affiliates in addition to Community Teamwork,Inc.,ARCD,Inc,and EVA«o'U"ACE, CERTIFICATE HOLIER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIV1wRED in ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOREMO REPRESENTATIVE ©9986-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD x 'Office of ConsUmer A hairs and Business if.eguiation 10 Park Plazg._ Suite 5170 Boston,Massachusetts 02116 Home 1Ln.Pro'vement Contractor Registration Registration: 1$0506 ry= Corporation MCRRMACIC VALLEY INSULATION CORP ExPiration: lV241201s TH" 260524 JOSEPH RYAN 23 A SULLIVAN RD BILLERICA, MA 01862 Update Address and return card,lllurL reason for cLzaoge_W __.. _ :,,•c.sz Address Renewal Gaf ylo'ment _. t 3 - Lost Card Ofnce of Carrsum r 1ffzirs 3 13w6acss Regulation License or reguistration rand for indixidul use onty 0PAE IMPROVEMENT CONT RAcTOR before the expiratiun date. If Found return to: % r?agistration: lgQSgs OftwE-ncc of Consumer 3fiairs aucS Business Regula€ion TYPe: pination.- YYl2412016 roa,oratdon 10 Park Plaza-sui;0517C ?LERR,1 AClCVALLEY IrssUL.RTiON CORP 13051011,M-4 02116 JOSEPH RYAN 23 A SULLIVAm ftp BILLERICFl i I1 L�41Sa2 p s+pt"V"..j�td.i•.�'ii out siminture of.PJ3id6:safe", _.'ce;tse:CS-075541 x 200 King Rail Dr,Apt'20i�� ,� ������a' Lynnfield P/A 03.940 - — s 1 t :acm.,4 st3z;n," 02/0412017