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Building Permit # 9/23/2016
,.yoRS4J BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received � Permit No#. �SS�cwus`� Date Issued: 3Et0_RTA_NT.Applicant must complete all items on this page LOCATION Print PROPERTY OWNERA(L T OY Print 100 Year Structure yes no MAP .,.PARCEL .. ZONING DISTRICT:-Machin Shop yes no Village yes no TYPE OF IMPROVEMENT PROPOSED USE Non_ Residential Residential ❑ New Building ❑ One family ❑Two or more family ❑ Industrial ❑Addition ❑ Commercial ❑Alteration No. of units: Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ IIVa - tershed District ' � �,��" e I �f � '.� ` ❑ Flootlplain ❑Wetlands ` y " � �' � � �� � .fir �* � � ,�' '* �� `� � vvn ��`'`�.:< �' iw..ra�'� �®.e�: w.;.er' wx"Z. m..✓fr.."; .� �'❑�Wat�ISe er.-fix#� "� ��� � � OP 6N®RK TO DE PERF®R1VI � _ �� �u ' ,. . ,;. . DESCRIPTION . •n � a •G o h a�- vse. ,�Cr' tic l •Ia�h'on �'a�- Identification- Please Type or Print Clearly OWNER: Name: T for Phone: (al $�`i �ZHZy Address: W Contractor Name: Phone: 5D ;s Email: Tn Y`^ Address: n O OR Supervisor's Construction License: 11 K Exp. Date: 8 I Zolq Home Improvement License: l$2�a� Exp. Date: ARCHITECTIENGINEER Phone: Address: Reg. No. FEE SCHEDULE_SULDING PERMIT;$12.00 PER$1000.00 OF THP TOTAL ESTIMATED cOST A tS7 ON$125.00 PER S.F. a2 Total Project Cost._ EE:$ 3,7 g 1 . F $ Check No.: _Receipt No., NO'T'E: Persons conbraeting with unregistered contractors do not have access to the guaranty fund �QRT� oven of z � ndover le�7 e o. 10.O L^KE h ver, Mass, . 'pq cac.sIC"xVVECx 9`PR�At S BOARD OF HEALTH Food/Kitchen PER Septic System THIS CERTIFIES THAT ..............UT ...x.04.......... .�P...�. ....., ... BUILDING INSPECTOR has permission to erect........... buildings on . .�i..... �: Foundation � Rough to be occupied as ......TUT. �Ir 'shall ,.. .. �i�,. '.�..�. .�.. .... Chimney provided that the person acceptingthis in eve res ect conform p p pevery p to the terms of the app Ica 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. �p �+ Final PERMIT EXPIRES IN 6 ®NTS ELECTRICAL INSPECTOR UNLESS C® T TIONRough Service " Final BUILDING IN CTOR GAS INSPECTOR Occupancy Permit required t® ®ccuZ!y 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. Fadoral 10#06-0405629 RISE, Engineering Rl Contractor Registration No 8186 MA Contractor Registration No 120979 ,k divisloin of-I'llickell Ellgi live ri rig C1"Contractor Registration No R ISE ENGINEERINC; 60 Slooviont Unit 112,Canton,NIA CONTRAG"I" (401)784-3700 FAX(,t01)7134-3"710 Page ..... 111tOGRAM TH YOUN RISE CONTRACT IS ENTERED 11410 BE.I LEIN1 A-1 I ES E .............. DE9CRIBED BELOW CUMIAVio Mattliew Taylor I Nr W DAIE ENT 0 WORKORDER 11 ,(,(0)17)839-2424 02/29/2016 1129635 00003 Moot ICE 5 INUT 99 Weylaild Circle 99 wCyland Orcle OFMICE C11Y,81KIE,ZIPBILLMO,MY,STAI C,ZIP North Andover, MA 018 4 5 North Andover, MA 0 1845 JO DESCRIPTION of miMenials to scall are Ts of Your holne apilinst\vastc tol,execs.,ail leakilge. 'I'll is work will be, performed in concert with tire use of special tools and diagnostic lots to assure that your home Nvill be left ovith a hellithIld level of air exclialigo:and indoor air quality.matelillis to be used to will yoor ionic Can include caulks,Inallis arrf other'piodueis,. Primary ureal.,[br scalint.,,,include air leakay, e lountics,basements,allached I,,aragcs and other Indicated aieov,,(windows are not 1.1,ellelallY addressed) 'I Ins will require(8)working hour,.A mitiction in euwc feet per minule,Win)of air irwiltrotion will occur,but the actual liumber of,C1,111 is not guirralliced. At tile Completion orthe%velithel ization woi I�,and at no additional Cost to tile hoinvownel.,it linal blowei door arnVol combustion StOty analysis will lie condude(j,1)),tile sol)-connaclor to ensure file siii'ety()['tile Indoor air quality. $680.00 AIR SFALING ADDER: (2)Nvorking hours. ass balls io t56)square fact t6r olamuning, C aio and materials in install a 12"layer 011?-38 allf,"Ced fiberl,"h $114M I R', all it 41"k -14 Class I Cellulose added to(1344)square feet ol'open attic XF 17 o) I(C iiin), materials to install ayer ot'R splice. $1,518,72 T t, r 7, al)()r allot materials to install 2" FSK Irived scmi-rigid fiiberplas �s bnal(I insulation to sof"are feet ol' knematl oral. $633.50 STORAOF BARRIER:Homeowner is responsible for the:removal ol'the stored items blocking tile installation of,weathelizatioll ovottl in the lowmall areas, Removal most occur prior to the scheduled\York start, —and materials to in's'—ula—te the back ot'(1)attic hatch with 2"rigid thermals board.Weatherstrip the perimeter. $60.00 '7'1F-- A HC A(777's-.7"rollill,labor and materials to insulate(5) block ot'llio kneemill hatch%villi 2"rigid'I'llermlix board,and seal file edge ol'the hatch with $300.00 777 V7N'1 I i X I FON 11rov;Ke labo, 711,11,77olow fo existing ballel ooln fall(s). $100,00 lor j",rov j�c To,=IVCI1lidatlOrY olaulailill ail floov $114.00 apply 4111 applicable,Cligij)lc incenlivo.to tilts conn-riel, You ovill only Ile billed tile Net amount. Curiently, for clipilllc mensilres,colullobia Ovs olki's 75%incentive,not Co exceed$2,000 per calerldior you-,and an incentive of 100%for the Air Scaling measures tit)to tile fitst$680 and art additional$3110 il'savings live justilled fly the andifor. For the sal6y and healill o)your home's indoor air quality,\Vc Will k COMILIClillp it plower door diagnostic ol"Ille avilihtIlIc air fIMV in your borne both before the vvoik is liqun,and lifter tie No,eallieri/alion work is complete.We will also Conduct al 1111 assesmilent of n , 1 eduraRI ID N 05.0406629 MSE En incclifl� RI Contrictor Registration No 0106 ISA Contractor Registration No'120979 RISE A division of"°I`Me1seh Cogirt£r£^ring CT Contractor Registration No ENGINEERING" 60 SiRwRtul unit 112,O nt£an,MA (401)784-3700 FAX(401)784.3710 Paago 2 1'12C:1ORAM 'TH SM1 CONTI'RAC'V W ENTCHI;:D INTI!OETWtEN NIS E' I ES r:NOINEERINO AND TIID CU,SI'OMRER FOR WORK AS ati''.jCRIUEO OELoW CUSTOMER _.. I'IUONC.1 DA'IL CLIEN'CM WORKOROVIR Matthew"f rtyfor ((r 17)839-2424 02/29/2016 4,28635 00003 SERVICE STREET" BILLING STRR:E.T 99 weyland circle 99 Wcyland Circle SERVtCE CITY,STATE,ZIP ... .... BILLING CITY,STATE,7.iP Ntartli Andover, MA 018,15 North Andover, MA 01845 .1013 DESCRIPTION lite Combustion sat"cty of your heating;ssymem and vvFttcr heater.`1 his has it w slue of" 90 and is at no cost to you, I otnl nliowahic wcRihcrization inccntiva is$3,110. I i Total- $3,781.0 Program Incentive: $2,940.01 Customer'rotai: $841.01 WE AGREE HEREBY TO FURNISH SERVICES COMPLETE IN ACCORDA14CE WITH ABOVE SPECIFICATIONS.FOR THE SCUM OF ,111"El ht Hundred Forty-One&01M00 Collars $841.01 UPON FINAL INNPEC'nON ANO APPROVAL.BY 1'4I3E PNOINEERIN0,CUSTOMER AGREES TO REMIT AMOUNT DUE IN CULL.INTL.R[`E81 OF I-A VALL UC,CHARGED MONTHLY ON AIIY UNPAID HALANCE AFTER JS DAYS.SEE(REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEOULINO,AND CONTTRAU'rOl'R RTIORS'TRATION, DO NOT SIGN T141,CONTRACT it THERE ARE ANY SLANK SPACES M� AIJTIIC)RIZID CIIONAI VITI=•RISE F'nokulolinS C,INSTC)M4',IR,AW,`E6 ✓ NOTE:71I1£9 CONTRACT MAYBE WITHDRAWN OY US IF NOT EXECUTED WITHIN DATE OF AC7CE.PTANCE ACCEPTANCE ON CONTRAC r I HE AHOVE PWC(,S 611KCIFICATIONS AND CONDITIONS ARF, 47 DAYS. SATISFACTORY TO US ANO ARP HERE OY ADCEPTC O,YOU ARE AU'INOI'RIZED TO DO 1HE'WORK �:...--.�.-..M-.. A9 SPEED)4 D PAYMENT Wit OF MADE AS OUTLINED AUOVC i .vit�,�Vu The ColN'®'monwe MiRft q'iw AdnBaWGichbM4d�els Department qfIndustrialAccidents y1oll, HA 02 114-2017 F � pq y y lvaqq.. µ ( 1p w0aw;^tv AMCreM atirrra 1Pasd%rMIc(,Affidavit:f Ienel°aal 01'rasi"esSes. TO BE 1x11.1KD W0,11,11111,1*1S111''s11'1""1'1fs G, 1.1'1°IIOR1TV" � 1r rrrak r�C.Jrpx,rrrrirart6r�r'% l ,rnt ;:ftlll!I C rty Energy rgy Address:PO Fox 64,11 �`' a l ttr Var��slc°lr X11"i 1)31(1!3 �. � tall� 3 I1-7923 1 Ilt>t�t�a� �$ ` Prr<t w;Parloyef r Ch k _.. w r rlr.w � re e yn%%area a%roalrlta;ycu �Ca�aeelr llua aCrfrr arl»er�ata G>a:arr: ��t�ara%trey ss�" �SP�(va^�gaain°axPJ): 1 1��I partnership f. ��(11��i�ur.%M^rer1?carg�,,rlei„1 �ta�rli�lrrewrc%�t i 6. .� .,. 1 an'P ti�swrlc� >%�°wa rs%etr�rr or and have no � (incl,real estate,<arltr, enrlaleaye c.s wonting,tibr taaw.inally c;apaeity. No workers'corn,. insoraarrce:culoiredl IR. { } Non-pro fit -, .,� y"v'e;are aP r~orpr>rta2"swrPr s%%-arf Its¢a1frcc% 1'srsvv s°xarrts6.,ecV 9. � � @awtcsrk;asPasr%vnt tltei% r%arlwr rrf esenyton per e. 152, §101 anal we Ir ve 1C1,� � ivlanttlacwrinj, no tsps%1%Yaapo [No svu laa%>"ww>taala insPrr arae. ravel%tPtccl] " I'l.� �� l les'altlr(';arc. ,I. 1 �sJw� arc a nowtrrcrfrt amp atas alter%a t ulfw sl by volt%rens a r s wide nwr K°rnocyees, 110 wetrlcerr,'con, sax,%%%auc e rc y.] Argy'4a ali€carU rVMat a:latrl.ra rrca;r,�I stars�Y h a<� purl r,r'.thw,a,ca,taoaa Mow sho dngr tha,u reorlra a r c.ontps u e ton policy al rc a ir� asP'it�at" � _.__ rlrftrraaa ll thts rocpolatr of Occr:a lovv vxrntptc.wl tkac,l*vivec;,but 010+rul oration lm rather c rryloyces..a v"orl rcvv a.erutpvarsan an policy is rccpta ivd and,mch.art crrrg;tru intion should c IIeck boaN I, I am aria a^nslalar3rn Plead is ivcr%arallacg avurkevls_crtraaayrearsardssraa lar.saaraarpa.c,.,,trrr past,,errrlr1gI,e s. Refino is lira lrprlsc,la lryMr'raaaaWerraa. ' 1%1."aMaYitrl4;k:1,.'C'r%Tlai%al./ "!'rllC InrVBrwAI"IC)R�r Insore°r's wlclrc.s,:One Sundial AVer)Ue Si.dte 30211 d�;it;yrfciYattwrl ilr: rsw 1%C'lat4l`, NH 013102 Policy It or sell-ifm N re fl 11,I\A/(.`y99896 ....... .... ...... � _ I°,xlru'ratitPrP Date *2912017 yJ;taah a Copymrf tl%re's worke'r's, a Ill pe la�Pfia'y aloe 121re"Parr&1Pt ltaafle(shcausiurt the policy muuttber tresawl expiration ala�f'e]. Fail%re.to Sc ttrwa coverage as r tswlaParcrcl Ptnslw,r 3a,c,thn 15A of MCR.r, 152 can lead tea Ow inywa Hion t;af el—in-tirraal plan tltiers ca1'a. r'itae up W S I,,5Of1AO atsrtlfc,>e e>tta-ye,ar iMprisctnraaC.Ptt,,:B tearll as civil 1,aco alties ill the taar%ax pal"a%`+"SOP Wu)T16t ORDFR t'nd as fine, orup to.ib:350AR)a day apinrsl plan vlwalsrtcar. Be wlelvireSc';cJ do a crerpty wafthk sfMatc,rrwnl nmy 1>e f,arevarw ul to the t.)file,of > wavr r a.,r art P iftw %trerePa _. Investigations,�%tiaras trl tl%c 1>f,,v far rarsn%Prrce c o �.v c car lef^,al ��� fills a amaall�reaulde a g1'lra p�Car`Ir that the faal"aramaldaara lsa�axtalalr,at above as true �. .... _m. _..�..- I alas las a a la, x c.astral carr r aac.1: Pholle fl:603-396-7620 _. (411dral use arrs(,y. Oo nol lv4te lra this aar°aeaa,to be con yrlvted lry ars"r,,or lorvaa c#fichlL h'ity tar '1'trvvPu:..m.. PerasWkwme ll ... lsstaival„A as hot°ily (e it cle one)- 1, ne)-1, Bo"rd of Ilearlth 2, Ruauhlsreel1l De^,IrmlPre ent 3,City/Town CkA I. I h siaar�t 13c'raw'd 5e SOe.etiarae n's OPRe' 6.(N her C'wawP&s'%d Person: 4WV41MS ll'M Q'*.�.p.w1Va(r1d ----, MILLCITY-1 AGOULD Dari:(MMrDD1YYYY) R® CERTIFICATE OF LIABILITY INSURANCE F7119/20 16 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(ies)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 License#AGR8150 NAAME:Clark _ Manchester,nce NH 031{32 PHE-MAILgNE _...._ _......._ -- One Sundial Ave Suite 302N Exti,(603)622-2855 FaC Nn_(6.031 622 -2854 E-MAIL ADDRESS:agould@clarkinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Arbella Mutual insurance Co 17000 INSURED INSURER S:Am GU Ord Ins CO 43290 Mill City Energy INSURER c: 106 Joseph St _.__....._.— --- PO Box 6411 INSURER D: 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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1 —-._..... —_ .._-- — _ ., _..... INSR .SUSA", ----�-- POL€CY EFF POLIbY EXP LIMITS LTR TYPE OF INSURANCE INSD VWyp POLICY NUMBER MM/DD MMJDD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 i � A AG TO RENTED �...,_..-.. CLAIMS-MADE L�l OCCUR 8500065735 04129/2016 04/2912017 pREMlSES Ea occurrence $ 300,000 MED EXP(Anyone person) $ 5,000 PERSONAL&ADV fNJURY $ 1,000,000 GEN`L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ 2,000,000 POLICY I J,SECT E-1 LOC PRO- PRODUCTS-COMPlgPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 {Ea accident) AX ANY AUTO 1020050919 04/29/2016 0412912017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ ..---1 AUTOS _ AUTOS ---__........_.. XHIRED AUTOS NON-OWNED PROPERTY DAMAGE $ X Peraccidenq AUTOS (...-.-.. $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB GLA€MS-MADE 46n---- 36 04/29/2016 0412912017 AGGREGATE $ 1,000,000 — _... DED X RETENTION$ 10,000 $ WORKERS COMPENSATION X PER AND EMPLOYERS'LIABILITY STATUTE ..__ ERH B ANY PROPRIETORfPARTNERlEXECUTIVE NIAMIWC791896 0412912016 04/2912017 E.L.EACH ACCIDENT $ 500,00© OFF3CERlMEMBER EXCLUDED? - -V (Mandatory In NH) E.L,DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 104,Additional Remarks Schedule,may be attached It 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 C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD i Pkiss, laua otts Departru er)t aat laeatairc aalaty � paarvlsr C t�irslr Itr°flirarr "�u ar 80arat all BuHrHng RsUW akceav;s .read,"�twwnd aWs Restricted to t7rtra slrrWd Buridort<s of any use carcaup avIvcla contain t..,ease: CS-110041 less than 313,.000 cubic feat(991 cubic ureters)of C:rsrr truciion '7espmsor enclosed space. MICHAEL JOY �� I 106 JOSEPH STREET MANCHESTER NN 03102 Failure to possess a current,edition eattlra Massachusetts i=:,Q iar rrat'm w We fluildir g Code is cause for revocuron of tills licause. C,exrlrrr i ssionma 08/07/2019 DPS Lkmsrut,l Information visit: WVA%MASS.GOV1DVS l�lre nwv raw°ler. istrallon valid terr anrlle ldai nrrw and t�ttuwa ail t ou'"rrwna'.trtair� au Oio atm �s Ftu�oel wrdasWw r � t° kGCDMh IM Ck�C'b/r Ydi MdP C Ma�l`"v ilea•eclaum6on d arae. Ittrrrrnd rdur`rr err: a 4,�� hra rip R4rcraaaW;� 'IR,2 tp"� 'C)tdYt�/�t:ttJMt 0 4r /a/ TyV*: tlttiee ral( onsumcrAf air. awl ttnalne�s tte6WIMIratr ria i > t /- 10 PmtµIwlar a Surte 5170 Baaala m MIA 071 I6 MAI e"ell Y r"tWEa'a4t`r" 11(,'. 7 0111CHA l r" MAM, WFltt.,S Ct:eR,NH 0 3ri't^ r ratrt i�wt�errc 1 m"IarwW°eWrraa rel ra r w'