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Building Permit # 8/31/2016
BUILDING PERMIT of Ill-r D A0RT116 TOWN OF NORTH ANDOVERto APPLICATION FOR PLAN EXAMINATION 4 Permit No#: Date Received TED C Date Issued: ------- J.MPORTANT: Applicant must complete all items 9n_this page . LOCATION k04A Print PROPERTY OWNER 90��CkO, Dona-Ack Print 100 Year Structure yes no MAP PARCEL: no ZONING DISTRICT: Historic District yes I Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE -ke-i7id—enflal Non- Residentia-I—� [I New Building [I One family El Addition El Two or more family 0 Industrial El Alteration No. of units: 0 Commercial xRepair, replacement - ❑D Assessory Bldg ❑0Others: F1 Demolition" [i Other an 9/,��,,'� Wetl NVI�� N"V61 g, JS WG 10 001/,,�1/4 01 NMI%, DESCRIPTION OF WORK TO BE PERFORMED: V)5W,-,& aAr� Q-0pe ins hQS-4--����cak An ins ALmH-1"-,ok1 Identification- Please Type or Print Clearly OWNER: Name: ?a;br�c,&o, �AQtrbn,�A Phone: rem)(eir -G7= Address: 104%A 5Wjxn S)r , w,�oOka Contractor Name: Wckw&A -Tau Phone: (3bAS&1-2o�o Email: ti Ad( kly-k 0AWS Supervisor's Construction License:- 1060,65 Exp. Date: -7 1..Joig Home Improvement License: IS110,L —Exp. Date:--7 12.07 12-0 n ARCHITECT/ENGINEER Phone: Address., Reg. No, FEE SCHEDULE. B ULDING PERMIT.,$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. .. Total Project Cost: $ FEE: $ 3 ........ Check No.: Receipt No.: Persons contracting with unregistered contractors do n©t have access to tZ gu anty fund IAORFi Town of = ? _ 4ndover 0 :. ®. tea_ as 17 h ver, Mass, 244P o "'. ' coc-'cnewKreR � s u BOARD OF HEALTH Food/Kitchen PE Rq 1,T T Septic System 0 LD THIS CERTIFIES THAT ................... ....l1 .......... G . !!�� . ......... BUILDING INSPECTOR ....... .. .. .. .............................. has permission to erect.................... ..... buildings on ....1 U.. ., . . .1.�.... ......... ........... Foundation s Rough to be occupied as ... .. . ... ! � �� .. �► k. ..., Chimney provided that the person accepting this p mit shall in every pect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and -L ws relating to the InspeF 'on,Alteration and Construction of Buildings in the Town of North Andover. ceI PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit, Rough � �� ® ® Final PERMIT EXPIRES IN 6 MONELECTRICAL INSPECTOR UNLESS CONST GTI Rough Service BC ...... Final U GIN PE. TOR GAS INSPECTOR Occupancy Permit Required to Occupy PuRough 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. RISE Engineering RE Contractor Registration No 8186 is MA Contractor Registratlon No 120979 K Is A division of Thielsch Engineering CT Contractor Registration No 620120 ENGINEER NG 60 Shawmut,Canton,MA 02021 CONTRACT T 339.502-5197 TAX 339-02-6345 ®�l� Page 9 PROGRAM sins cournACT� o urre aarvr��u a�a CMA-HRS r.KGMESUNDAWDLECUBMMERFORwoMas MI oMMED ar r ay cuarose� PHMuA raUarus a WORKOWER Patricia Macdonald -< (978)6186780 02/03/2016 427010 00002 amvlca smr;V d BUNG GTMET 1044 Salem Street 111044 Salem Street c. eanUmE enY,aTATE.ZP eataw CM.STATE,ZIP North Andover,MA 01845 North Andover,MA 01845 DESCRI"ION AIR SEALING:Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concen with the use of special tools and diagnostic tests to assure that your home will be left with a healthful leve!ofair exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics,basements;attached garages and other unheated areas(windows are not generally addressed.) This will require(8)working hours. A reduction in cubic feet per minute(efrn)of air infiltration will occur,but the actual number of efm is not guaranteed. At the completion of the weatherization work,and at no additional cost to the homeowner,a final blower door and/or combustion safety analysis will be conducted by the sub-contractor to ensure the safety of the indoor air quality. $680.00 AIR SEALING:Provide labor and materials to install Q4on weatherstripping and a doorsweep to(2)door(s)to restrict air leakage. $150.00 ATTIC FLAT:Provide labor and materials to install a 6"layer of R-21 Class I Cellulose added to(240)square feet of floored attic space. $427.20 DAWAING:Provide labor and materials to install a 12"layer of R-39 unfeoed fiberglass batts to(84)square feet for damming purposes. $172.20 ATTIC FLAT:Provide labor and materials to install a l3"layer of R-45 Class I Cellulose added to(440)square feet of open attic space. $717.20 AT'T'IC ACCESS:Provide labor and materials to install(1) easily moved,insulating cover forthe attic access folding stair. A small flat surface of plywood will be created around the opening within the attic. This will allow the cover's integral weather-stripping to restrict air leakage. $237.65 VENTILATION:Provide labor and materials to install(1)insulated exhaust bole with roof mounted flapper vent to exhaust existing bathroom fan(s). $118.75 VENMATION:Provide labor and materials to install ventilation chutes in(5 1)rafter bays to maintain air flow. $102.00 BASENIENT CEILING:Provide labor and materials to install(142)linear feet of R-19 unlbCed fiberglass insulation to the perimeter of the basement ceiling at the house sill. $248.50 RISE Engineering will apply all applicable,eligible incentives to this contract. You will only be billed the Net amount. Currently,for eligible measures.Columbiaoss offers 7595 incentive,not 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 are justified by the auditor. For the safety and health of your home's indoor air quality,we will be conducting a blower door diagnostic of the available air flow in your home both before the work is begun,and after the weatherization work is complete.We will also conduct a full assessment of the combustion safety of your heating system and water heater.This has a value of$90 and is at no cost to you. Total allowable weatherization incentive is$3,110. $90.00 i i N Federal 10#050406629 ' 7. RISE Engineering 1:I ca�ctorl�i,�aa W NO 8186 MA ContraetorReghfttfon No 120876 RUSE '� A division OrIblelach Engineering CT Contractor Reglstratlon No 620120, ENGINEERING 60 Shammut,Canton,MA 02021 CO T V 1,��wT 339 MM197 FAX 339502-6343 Page 2 PROGRAM TTCS CONTRACT f5 EDRF1IEDfMOOE1NA?0 Rt8l; CMA-HES o 0AM! CM0T E PCRWO'U As CUSTOM PHONE DATE CLIENT 8 WORK O"zR Patricia Macdonald (978)618-6780 02/03/2016 427010 00002 BEAVICE STEW- r Balm eTRBCT 1044 Salem Street 1044 Salem Street SERVICE CRY,WATe W SUMS CRY,BTAT@,ZW North Andover,MA 01845 North Andover,MA 01845 JOB DESCRIPTION Total: $2,943.60 ProBlram Incentive: $2,400.13 Customer Total: $543.30 WE AGREE NIROY TO FURNISH SERVICES-COMPLETEIN ACCORDANCE VMTH ABOVE SPEC(FICAtIONS.FOR THE SUM OF ***Five Hundred Forty-Three&381100 Dollars $5413.38 UPONRIPEOTIONANDAFWROVALSYRWENOMEERDHLCUSTOMERAGREESTOitMWAMOtWDUEWRJLLWMRESTOP1%WILW*MUDMONTHLYONANY UNPAID AMR30DAY&SEE RMaMFORWORTAUTWAMM71ONON OVARgHIBES,R1Wi16CFRECtBdCN,OC1fEOOLLNO,_ANOCANiRACTORR TRAYGON. 00 NOT SIGN 1}l!5 Cp[dTRACY iM� Y MMIOR ZEO SIONATURB- Ertgl WW[Ho NOTETWSCONTRACT MAY W MTNORAWNOYUSIPNOTis7MWEOVIf=N OATEOPA01%MANOE � �,��/`•�' -- ACCEPTANCE OF CONTRACT-M ARM PRNCRA,8PHC F=TIONS AND COMMONS ARB iii ffA718FACFORYTousANDARE REREBYAWFJRIED.YOU ARC AIMORMEO7OOOTIM WORK AS 8PECIFFEO.PAYMENT VA.L HE NAOEAB OUTT,WMASOVE e r 1 .f SE 00 Shawmut Road,Unit 2 Canton,MA 02021 339.502-6335 ENGINEERING www•R[$Eenginsering•com Efficiency Cn ergiz�c:. OWNER AUTHORIZATION FORM Patricia Macdonald (Owner's Name) owner of the property located at: 044 Salem Street, North Andover, MA (Property Address) (Property Address) hereby authorize S l , (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 I i I 3 ``...._ The Ccrtwiwtrteaftft (ry"Afli °s cf usells Iofi id".r";Street, suik lot) Boston, AM OUI 02012' ..v t=mango /tfiii Workers' oni'rensafiran Insitrawe Af ia'Isavi9t Ge1jtr^nl'13rrswric waaaa. C: ai ire . sdG)k tar�irzaEir�t`r Nair a-!dill C!ty Energy 6"addres,,:t10 Box 64,11 V 1tncIaa tcmt, Ni 103108._ -C/ 6303-.3911 7923 Are you an employer?C lw ek the a;iprp rop>Ate Irux. �.. _ RuMnewi 11p e(required): l.� 1I „r. 0f3awtaail �" errairr a ci�'�1cr; a.r wviti't a e�,rra rla>, ers full airra;lf paart do ).* Ci. 1Castaiur rnt/E3aar/1 itin I statrlk'huleut 2.C 1.arra a wile parcrlmric.t,or or tronnem[lipr and have no 7. C,HIFire. andAw Sales(int;l,mat e.staw,<aim,eta) cyrngalery,cs,working Liar file in any Capacity. 1' B!o wrrcrikcrs'conipi. insur,u cc requirce9y � £la n pircrfi't. ;3. � . We area empau'ration and its crllre ers have ca:erciscrtl 9. luutc.rlaiii hent klrcit ri¢3g7t arf'ewruptiarim per,e, 11,§1'1l'„duel we have 'Carar.rf"ac'turi�np; no employees, [No wvcalae,rs cornga, insurance required]*", llfeahli Care 1, y�,.,atrc 4a rMa�rragaicaGit riry ntr�attiern �,tauflacl Iry+�+ninnta r,r<,, wwhh no crnpaltrycc% [Ah)worlcwN'winy tri,»urtince rc'q.{ 12.� C:9thrrm f\n,y s1 t rfoWyitr rkr rr i ii+�d�s 6riMit€.I«tati idciw i ur"flwk e girth&i Cniirarnr zltuu Policy iii(ria'rn aims, sI 011c corpreai°aiki, Ina&c cmpxr w m Sri r uigiociawpricay i^m a avrmiptiia,i i:arwipreiribazrion policy is rcrqui el iar0such an <arg main lion sitrriiald cheictl,bo",rft. I any an r^rarudrWer that is pe°rrriadhr g r orkerrs comrapar_iraation hisurrierc°r fizr nq eirrpfir t,etr+e. Relow is the p alb:1,h?fow°rrsrrr"perii. Cnsurmatre C'rruilrrany Narnc,_C'wtk w s11raiwe� fn,�kiarc°r°";a tfelrc..�s;("arra,Sundial Avenue Suite 3022 0'l:,y/`3(altwa x,ip : n/Vrirrr,h ;it a, NH 03,102 Irolie'y� q.or` 14=h7s, 1 rc t'f MIVVC7 91896 prge(a ---t;xq>iratic�rr lh�rtc '1129/2017 A ar h as a°aapay Othra�t mvcaw 8srr ' r,eaaiaparrastatinrr erfat.',y'al�clarsitrarri (ii;%,lWe piaalky number aracl e piarartlun daatc), Failure to'secure cure cov z ige as required under Sc,Won 255 or N4GL e. 152 can land to that'.;ivapacrsiit.iern t'r1'c rldnal penaltieas of ar MW up to$1,NWAO and/or one-year intpHscinme.u't,as wyell as ciAl paenahie s iia die 1atm atf ar STOP MARK ORFWR and alines of up to 4a250JR)a day agMwa Me vft)larttar. Be WvAal do ar ceilr'y^of dri s stmernwit pray lac phwvarcleacl to Me C.)t'f°iCe ut' Investigations ofdle DIA for inaaurarncc rarva:,a-age verification, !do he r el^ yx,erlif a,at this aanel,pac,n aliie s arf prarrfiaq th al ill,,,iglaarm aterrrr provided d above is true and c mwwl, �3v� .a�� ,. w ... 603096 452) _ __----------_.._..__._ e-�If iclzzl za.we onljC� Do not writes bra this tare a,to be ceerrif4eled liar vi�ya zrrw town irf f sial, Cly or lbw n -.-_ _,. ._....,___ _law°urw'si/Lrcrsnsre0 Ir-asning 7w uthority(ch-cle cove): 3, I3rrarcl,rf°Health I RnUWg t eflaar•tmwit I C:Ity!'t"mui C'Wrlc C lAmnsing Hoard "ufdcdrinasiaN CDI`Ace Oro.talar Wntnd IP"wnt Phone rwGvaV.ntnwptnRliri..___ �p1 MILLCITY-1 AGOULD Ftl`19/20116 (MMIDDIYYYY) 111-� CERTIFICATE ®F LIABILITY INSURANCE 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 endorscment(s). ACT PRODUCER License#AGR8150 NAME: Clark Insurance PHONE PAX Arc Na Ext]: [Arc,Nn): 60_3 622-2854 One Sundial Ave Suite 302NfiO3)622-2855 ( ) --- Manchester,NH 03102 ADDRIESS:agould@clarkinsurance.com INSURER(S)AFFORDING COVERAGE NAIC 4 INSURERA:Arbella Mutual Insurance Co 17000 INSURED INSURER a:AmGuard Ins co 43290 Mill City Energy INSURER c 106 Joseph St _._-..._..... - INSURER D PO Box 6411 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. IR TYPE OF INSURANCE A15TiL sUI*�E _.-,...._....,.._.._.. ._ POLICY EFF POLICY EXP LIMITS LTR t SD POLICY NUMBER MMIDb MMlL10 A tXC.CMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 D AGET R•N CLAIMS-MADE OCCUR 85DD065735 0412912016 D412912D17 PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 JECT POLICY PRI- LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO 1020050919 0412912016 0412912017 BODILY INJURY(Per person) $ ^ ^^ ALL OWNED SCHEDULED BODILY INJURY{Per accident) $ _... AUTOS AUTOS X X_ _____.. NED PROPERTY DAMAGE HIRED AUTOAUTOS (Per �denL $ $ )( UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 r A EXCESS LIAB CLAIMS MADE 4600065736 0412912016 04/2912017 AGGREGATE $ 1,000,000 DED FX RE ION 10,000 $ WORKERS COMPENSATION X PER DTH- ': AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETORIPARTNERIEXECU€IVE Y!N MIWC79'1890 0412912016 0412912017 E,L,EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N I A _.................._..._,�_, - (Mandstory In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes.describe under DESCRIPTIONS OF OPERATIONS below E.L,DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS 1 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 Town of North Andover MA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1600 Osgood St. ACCORDANCE WITH THE POLICY PROVISIONS. North Andover,MA 01845 AUTHORIZED REPRESENTATIVE I I 9 ©1988-2014 ACORD CORPORATION. All rights reserved. 1 ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 3 7 t Massachusetts Department of Public Safety Board of BuiirllrarJ Regulations and Standards License: CSSI--106035 Construction Supervisor stzeci aily G MICHAEL JOY is ni 106 JOSEPH STREET' � MANCHESTER NH I r--j':z Expiration: Commssuon!:r 08/07/2018 ur..rnlrtr^E rr�f a '/(f,Jrrrr° r�;e+f/� License or registration valid for iudividul use only Office of Consumer Affairs&Busi�llss Regulatiuo � r .) )OME IMPROVEMENT CONTRACTOR before the expiration(latc. i1"found a return to: tegistratian: 182792 Type: Office of Consumer Affairs and Business Regulation t Ohl if),Park Plaza-Suite 5170 �a Exi�iration: 7/27/2017 LEC Boston,MA 02116 MIU!.C iTY ENERGY,LI.C. , MICHAEL JOY l 106 JOSEPH STREET � MANCHESTER,NI-I 0;310 CMnilrasaurctrary� � N � wn as vitluaut s priqtune