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HomeMy WebLinkAboutBuilding Permit # 9/30/2016BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received__ --- Permit No#: Date Issued: Applicant must LOCATION � Print PROPERTY OVVNER-----yes no Print ioo Year structure MAP PARCEL: ZONING DISTRICT.'—,—Historic District yes no Machine Shop Village yes no OWNER: Name: 7 Address: ­10 -1 Contractor Name:----" DE5CR1PTi®N C7 TO BE PERFORMED: fi,­ . 6nd I Ab * J-,? O&r- 4k rommorl w-aA1SL------- 1(jentifleation - FPlease Type or Print Clearly Phone: �aL-7 lam Address: --?-o License: Exp. Date:_. Supervisor's Construction _--J—W4k �-- I Home Improvement License:—. 182.1017- Fyn- Da ARCHITECT/ENGINEER Pho Address: 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: Check No.: —Receipt No.: ?`77 NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund igs 71 LA � w o D O co C ° a LL EJ to Q N V7 t LLIw a z Z co CLU OQJ +`+ -0 C 6 LL CC 73N a K 7, .0 V _ C LL t Z bZ a _ m C IL ce w CL U b J txo7 a d' cel •7 y � m C J -L nc p Z L tw = a,- m G LL z w W a W j to a Z LA G7 N Y ° N Cob yr f u P. CD O O i O w CD 0 U) CD •� r. • m V/ rrry O IOD Cl 0 ". O CL CL ca C)�Cc .Q O CD 0z 0 CL CL N The C.'onutiorimleulth qfMosviehuseits Departmeut low A E� 11 V -Yeti � J� 0A, .1 ("ortgress Vtreel, Suite /00 Bostori, A111 0,21,14-2017 wmld Uel worl(ersl (Aunpensmimi Insurinim; AMduk (kmwg BmWmws. V) HE FILED Wk,111K TIM: V11,11011ITTINK"', AU1,110111TY. HusimNsMIganIzallo" Nam a RMH City Enemy . Adcliess: PC) Box 6411 NH 03108 Phone jh 8013947923 my you an empWyed (1"k Me appivp&le box: 1. ✓ 1 am to employer with ernployces (full and/ or PNHM4* 1 wn as sole pimpriow- or partnership and have no employees working fiver live iri any ciq)aoiIy. [NI() insuravicc require(]] 3. Woalc as corporation and its officers have exercised thdr right of excrillfJon rwr. c. 152, § 1(0, mull we We no emoorres. [ cw wo,tcrW tmmphistiravice aquUM11" \\,,e are v non-rImM orgmAwho sialkd 4 viAnimers, with no cillployecs, [No worl,,,ers' couip, instmovcc r(ar, I P! t Se fat int q„C�Lly HuMn ess Type (rwIldred): S. (j Reit ail 6. T Office andkil-Stiles Oiler. Mal (-.Statc, Into, etc.) 9. limit 110mmmiketurog 111-1 walw cue, 11Y Orher ,J;paUnw Sm wn'Twxdal rill mathe sec6olOwdow ','I iov,41�011,,nq wotkers' conlpor ilkolljKsll(w, III RIM)At I ,If ille Corfu) I ate ot I iccns I lave exonpiv' d Ina iho coqmratimlhx; Wier ClTyloyms, a wotkef!C Volripewation policy Is requi I M am I r,kicll ai I sWWd di"i Nm N I In uraul; Conipally Nunn= kimwerl Ad&m% One Sundial Aventre Suite 302N N Ila nc; rieste r, NIA 03102 pojic,y 11 �1�, '791896 4UW2017 - e,,, SL rj, jj NIIVVC� HOW& DMO Pe P( Y d Alig the Isolky fivuriberand expindlon dnld). A"mh a vMy dthe woril"�rlll` AM w smwe awmAge as required under Sea. icro 25A or MCH. e. 152 can lead to tho iinposition oft.rinnual penalties of"a Orm upioSh%0.00 nnd/orone. -ye,,ir hoprisorrinaliq as w 1 as ciOl pcndtbq in the Ann artYAUP WORK ORDER and a Hm, ol'up lo $250MO a Q ap[nM Te dola90r, lie, advised thta a Copy of' this statement rnay be l6rvvavded to the Office of Investigations oflfie DIA for instirance (Awcragc vevil ication, do /lair vkr cerlilj,, as 6030964520 andjoenalfiev qf'j)erjr11j- that the h?fi)rnwfion jlrovidett above is hwe and correct, 2-0t(o owhqw Use 0111)'. Do 110huRe ill this area, to be colly4eled fi), 6(p Or towls qjficiat (Aiq or Town- PeriadUlAcense If ksking Audiodly PAN ono, L Jillard cal' 2, Buildhig Deparbuclit I CHY/Towil (Aerk 4. Licensing Board S. Selechilculs Off`IC4e & Other (Airoact Iferson, wwwMM"gowdia SUMMM MILLCITY-1 AGOULD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 7/19/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License # AGR8150 Clark Insurance One Sundial Ave Suite 302N Manchester, NH 03102 CONTACT NAME: PHONEFA7C......- Arc Pn,_Ext): (tiO3) 622-285855 ---...-.. _ Arc No : (803) 622-2854 A DRESS: agould@clarkinsurance.Com INSURER(S)_AFFORDING COVERAGE NAIC # 04I291201$ _ INSURERA:Arbella Mutual Insurance CO 17000 $ 1,000,000 INSURED INSURER B: AmGuard Ins co 43290 INSURERC : _....._,..__...-,--_-._,. Mill City Energy 106 Joseph 5t PO Box 6411 AGGREGATE LIMIT APPLIES PER:GENERAL PRO - POLICY � JECT f I a LOO OTHER: _.., _......,....,.,_, INSURER D $ 2,000,000 PRODUCTS - COMPlflP AGG Manchester, NH 03102 INSURER E _--. ,.......2,000,000 INSURER F: AUTOMO9ILE LIABILITY X ANY AUTO - ALL OWNED SCHEDULED AUTOS AUTOS X NON -OWNED HIRED AUTOS AUTOS 1 r_nVFRAt:FG CERTIFICATE MILIMIRER- 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. INSR LTR TYPE OF INSURANCE ADD INSD -S B D `- "" "'"" LI POLICY NUMBER POLICY EFF MMIDb POLICY EXP MM)DqNYM LIMITS A X COMMERCIAL GENERAL LIABILITY OCCUR 8500065735 04I291201$ 0412 912 01 7 EACH OCCURRENCE p 5E& RENTED AMACLAIMS-MADErX1 E9 Accu nce) $ 1,000,000 $ 300,000 GEN'L -MED EXP (Any one person) $ 5,000 RERSONAL&ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER:GENERAL PRO - POLICY � JECT f I a LOO OTHER: AGGREGATE $ 2,000,000 PRODUCTS - COMPlflP AGG $ _--. ,.......2,000,000 A AUTOMO9ILE LIABILITY X ANY AUTO - ALL OWNED SCHEDULED AUTOS AUTOS X NON -OWNED HIRED AUTOS AUTOS 1 1020050919 0412912016 04/29/2017 Co""1 Ell SINGLE LIMIT Ea accident $ 1,00fl,fl00 BODILY INJURY (Per person) $ _,__. $ _.._,......._._.__ BODILY INJURY (Per accident) PROPERTY DAMAGE - (Per accident) $ $- A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 4600065736 0412912016 0412912017 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ B WORKERS COMPENSATIONJ( AND EMPLOYERS' LIABILITY ANY PROPRIETOPARTNEWhXECUTIVE Y! N RI OFFICE"EMBERFXCLUDED7 N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA MIWC791896 041291201$ 04!2912017 STATUTE-„ ER E.L. EACH ACCIDENT _ $ 500,00 ----.-...--..-.-.— E.L. DISEASE - EA EMPLOYF $ 500,000 -----------_, E.L. DISEASE - POLICY LIMIT _.__......_. T 1 $ 300,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 161, Additlonal Remarks Schedule, may be attached If more space Is required) 1 I=QTIFIt'.ATF Flnl r1FR CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ".. FRISE ENGINEERING` 60 Shawmut Road, Unit 2 1 Canton, MA 020211339-502-6335 www.RISEengineering.com DLY��4�1•� (Owner's Name) owner of the property located at: ( (Property Address) �11 �f4i .Af A U � % 4 5 -- (Property (Property Address) hereby authorize PIZk (Subcontr 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. Ther Permit will be secured by the insulation contractor, at no additional cost. it is the homeowner's responsibility to close out this permit by contacting their municipality at the completion of this work. D �,kO o _ " Date 6.2016 Fadorat ID # 05-0406629 Rl ContractorRoglstratlon NO 8186 11!51: Engineering MA Contractor Replstril No 420970 CT Contractor Reglstratlon No .. ��'"`' 60 Shnslmist Hoed. Caniun,'MA ®N`TF��4�7' ENGINEERING- (401) 7843700 FAX (401) 784-3710 Pago 4 PROGRAM rRIS COUTPACT IS ENTEriED INTO"WEEn RISE CMA -HES � E� tE CuBTOUEH FOR WDRX tis e'us'l _ DATE CUEara wonlxoaaER da!ieph Ninartino(978)682-7 i 74 09/12/2016 438115 35002 allymce arAELr .. .. rul.vNa aThr 107 Stagecoach Road 107 Stagecoach Road �Vi Lam. arrevlcE crrr,srArs,Zip tuwl'ta crrr,srnTF-ZW F.., _.-.-.._. .w•.....- ....,,� North Andover, MA 01845 North Andover, MA 01845 JOB DESCRIPTION AIR SI3Af_11(.i: Pmvidc labor and materials to seal auras ofyour home against wasteful, cxcm,; air leakage, This work will ha W---- perlbrmed in concert will the use orspeaial tools and diagnostic W%Es to assure IElat your home Will be lett %4ilh a 1lealdlfuE eve) or air exchange and indoor air quality. Materials to be used to scat your home can include caulks, foams and other products, rimary areas l'ur sealing include all Ecakabc to aaics, basements, aanchcd garages and other unheated ureas (wmdDW,S are not gri nddre sed,) 'phis hill require (5) working, hours, A reduction in cubic ll per minute (ef n) of air infiltration Will occur, bol the actual number of cffn is riot guatanteed, At tfic completion ortllc weatberization Work, and all no additional cost to dlc homeowner, a final blower door ar for combustion 13fet3, analysis will be conducted by tltc subcontractor to ensure lire safely orille indoor air quality. $425,00 DUCT SEALING: Provide labor and materials to seal Venting and/or cooling ducts within dcsignalcd unheated areas. 'this work %VIII be pert'orrrlcd at the sate ufS75 per man per hour. which includes materials. (4) working hours. 5300.00 A'tl'1C IrLA7": Provide labor and materials to install a4' layer of il14 Class I Cellulose added to (543) square feet ofopen attic space. 5613.59 ATTIC ACCESS,. Prtwido labor and materials to install (1) easily moved, insutaling cover for the attic access fbiding stair. A small fiat Sill of plvw(1(Id will be created around the olletling wilhm the alae. 'Igns will allow the L'over's lnlegral weather- stripping to restrict air leakage. $237.65 COMMON WALLS: Provide laborund materials to install R.13 unfaced Fabergluss to 31 square reet ofcnminon wall. 'Chen inslall 1 " rigid board insutalion that me el file sections R-316.5.4 and 316.6 requirements ul'building code. Seal all scams wish VSK tape. S113,1i COMMON' WALLS: Provide laborand materials to install 2" VSk fated semi-rigid Eiherginss board insulation to (150) square text ofcommon %vall arca. $52.5.01) Provide labor and materials to instal! R_9 t'aced fFherghtsS instllatiOn ED the exposed heating andlor kaolin(„° ducts in certain non- eondltillnkd areas. 'total to he inaiillcd aS (73),,clVare legit. S208.05 R1S1: lin3meering loll! apply ll! applfcablc. E IEt E171e' hrckultvks !tl lllis knrllraC[. You will only he billed the Net unlount. C uttci ly, for eligible nleu_sares, Columbia Gas o(lcrS 75° o ineennVe, Ilnt to exceed 52,001) per calcndnr year, and all incentive of 10041. l'or [lie Air Seating ni usure,K ill; to the f irSl ,$8110 and all addlliomil 5340 irsaviagti (Ire justified by the auditor. For Ille safety and health ollyour IIomC s indoor mr quality, we will be conduclmg a blower door diagnostic ortile available air 11,l%' in vour honic hodr before the Work is begun, and after lba wewlicrl[atlon work is Cmilplele, We will also conduct a full assessment of the combustion snfety ofyour heating system and water heater. 'this has a value orS90 and is at no cost to you. 'total allowable weatherizatfon incenlive is $3,114. RISE 1 11'IE't'1'll� Feda111110d05-M6629 RI CDRlit(TIM R0 fauoti No 8186 I�Irallan No 120979 PAR GontTRGinr R�IElr�tion PJD RISE CT CnntrAr--lor Ray ENGINEERING'iElt'Shea "ItH Hnad.1'sntun, 15.4 14011 TN4-3(ktCONTRACT t•.4X taut I 78.1-31111 Papa 2 111MOtAM 11111ctmTRAr.715 ExTEJIEDrNTC DE7V LER rusT C,MA-IMS E4,3"r% ,3"r RAND THE CU9T0ll<ER fOR WORN A.g OE ScninED BELOW CL"TOMPA DATE CLIENT WORK ORDER h t3il��artiix, rw�NE (97 8)682-717-1 0911'2;20 16 438716 35603 5EAVFCE STREET SILLINCl STREET 1177 Stagecoach Road 107 Slagecoach Rodd sET'NCE CITY.STAYE.TIi, IlILLINO nn, srnrE, r1P '�LTrth Andover, MA 01845 North Andover. MA 01815 3013 DESCRIPTION ��1E.Ili, ll P i Total. $2,512.44 Program incentive: $2,088.08 Customer Total: $424.36 WE AGREE HEREDY TO FURNISH SERVICES-COMPLETL 1N ACCORDANCE WITH MOVE SPECIFICATiDNS. FOR THE: SUM OF 'Four Hundred Twenty-Four & 361100 Dollars $424.36 UPONrItALI144PECTtV; AND APPROVAL BY RISE cNGmLERIIfG. CUSTOMER AGR[CS 70 RFJAIY MDUNTAUEI'I I U13_ IUIEREST OF I. V, =I CONTRA TOn RONTItLY CN A-N UNPAID UALANCEAM-1130 DAYS. SEE REVERSE FOR IMPORTANT311FORMATIOR Ott GUARANLEES,R101115 OF Rf:CI_,ION, Gfl1EOUu1ip, OO NOT SIGN THIS CONTRACT IF TIAERE ARE ANY BLANK SPACES � / .• Irl F�I�Y A(MfORtZEO SIONATURE• RISE r.10K aAOU GU 70iF.ERI/ ITq'Cr- r:OTE: TI113 CW9TRAOT)AAY OE VITHORAWN OY US IF NOT FXECUTEO WITIIII} DATEOFA..." NCE: 'L ��', r 1, 4'W ACCEPYANCE OF CONTRACT - TME ABOVE PIAMM SPECIFICATIONS AND CONDMORS ARE r SATISFACTORY TO US AND ARE HEREBY ACCEPTED, YOU ARE AUTHORIZED TO OO THE WORK �' DAYS. AS SPMM-D. PAYrAFNT VOLL OE MADE AS OUTLMEU ADOVE MaGG,10USPUG Depaiitment of PUI)HC &1cty Construction Supervisor Board of Bt,.d[cfinq Regulaflons an(j Stq�I&Ircjs Rostricted to: UntesUicted - Buildaigs of any "se gfoup which contain Ucenser CH 110041 less than 35,000 cubic foet (091 cutAu meters) of f-'onstrucfion Superimor enclosed spaco MICHAEL JOY 1106JOSEPH STREET MANCHESTER NH 03402 Fa1ure to possess a current edition of the Massachm"fis State Buildif E xP i ra bon 9 Code is cause too" revocation of this ficense. Clownissioner 08/07/2019 OPS Licoosintj information visit: WWW,K1ASS.GOViDPS 1/1 T I ( R -A, HOW, f PC i fl?742 yypc itr, fa 7,12NDV 7a2, b0mv 11m expiiatkm dmr� It found r0uro (w 01ficV44( owurucr Alfgh,€Anel Wflnvkllhiri "� uitt,5170 goqou, NIA 02116 A r N( r id vithout 4i r, mv