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HomeMy WebLinkAboutBuilding Permit # 10/28/2016 ,%ORTh� BUILDING PERMIT v��YLED ,6�1'O TOWN OF NORTH ANDOVER 02 APPLICATION FOR PLAN EXAMINATION ��qt Permit No#: S` - �o l'7 Date Received t 0 " k0_14' ��oRZD sSgcHuse Date Issued: r — � it IMPORTANT: Applicant must complete all items on this page LOCATION f� f''(t.4dowao d Print . PROPERTY OWNER &56 cK t'rint. .. 100 Year Structure yes no MAP. PARCEL: ZONING DISTRICT: Historic District yes ` no Machine Shop Village yesno TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Industrial ❑ Addition ❑ Two or more family Ll Alteration No. of units: Li Commercial XRepair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other .. a� aR r v w a FI ° Il �53knm Y' G.fir, � e s i ., �llfell ,y; ; oodl irt' ed Q pct �v,,s? �nom. � � " ✓ ��.�� i 1llfaterwe fi z .' F , &y.. '�, � �h DESCRIPTION OF WORK TO BE PERFORMED: air olamrniinsuA �•, b •s �, s ' �a� i r Identification- Please Type or Print Clearly OWNER: Name: r'3av1 lnll,e.c,K Phone: 97 83s� 7 Address 62 Pd, Alom ovc.,� KA DINS Contractor Name: }�liGh u Phone: Sb$ 2-Zo Email: in& CA Add`resa =(o t Supervisor's Construction License: t!'Q Exp. Date:......T1 10t Home Improvement License: 1L a Exp Date: 77 Z 20► � ARCHITECTIENGINEER 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: $ FEE: $ 3 Check No.: 1 Receipt No.:�3/ OJ NOTE: Persons contracting with unregistered contractors do not have access to the upraw fund w OORTiy own ofndover _ 6 O �' 0 AM 434w-�i 7 0 '�-A�! h ver, Mass, • 0 C4C..1C.alWICR • S U BOARD OF HEALTH ■ Food/Kitchen IIIIIERMIT T LD Septic System 'ES THAT ........)".!&AA1.!! J............. `.o ....,...................,..........,.......,.......... .. BUILDING INSPECTOR .'. in to erect .......................... buildings on ....j..�...... ! �I .. l.�........ Foundation .. p � ..$P c M. . .. ....... .......................r. .. . L . ....... Rough 'd as ...., ...... . . .... ... Chimney the person accepting this permit shall in every respect conform to the terms of the application Final office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and of Buildings in the Town of North Andover. PLUMBING INSPECTOR f the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONSTRUCTIO S RTS Rough ......... ... ...4..�. ................. Service Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit required to Occupy Puildin Rough ay 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. , r r RISE 60 Shawmut Road,Unit 21 Canton,MA 020211339-502-6335 ENGINEERING www.RISEengineering.com - Enc-reit. .. OWNER AUTHORIZATION ION F (Owner's Name) owner of the property located at: Cal t"-e qdo 00cc (Property Address) /�• Igo a.. (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. 1/, kke, Owner's gn ture- -7A'qli(o Date Fedoraf ip R 06.0405629 RISE, Engineering R1 Contractor Rogistration No 8186 PAA Contractor Regintraifon No 120979 A division of'lldelsch Fugineering RISE ENGINEERING' Company Address,City,\i:1 000116 CONTRACT 401-123-1234 FAX 401-123-1234 Page i PICOGRAM CNIA-I1IN- EHONEEEEaINOAHR•�CuoUM s �W'[�1WAs OE3 MOVD9Et.0YY costo eER \L CV[ PHMM DAM CUENT9 VIM*Mk Alison Devitakuhh6t ! (978)835-3271 07 JW2 I a CERVICE MUMET plUM0 GMEET 62 Meadow•ood Road 62 Meadowood Road F t 1 11111 SERVICE CITY,BIAIF_ZIP G1WN0 CITY,sixyE,ap �. ' is+ l.j 17 North Andover,MA 01845 North Andover,NIA 01845 iLU tS JOB DESCRUMON HEALTH&SAFCTY:Wcatherization Mork cannot proeced ta[til mCchanical ventilation that ui€I provide(0)cfnl(cubic feet per minute)of continuous nir flow hws hccn installed in your home. 50.00 AIR SEALING:Provide laWr and materials to scat areas or your Monne against vmstefal,excess air leakage. This%var1 15111 iX: performed in concert smith the use of special tools and diagnostic tests to assure that your home will be lull with a heatlhrul level or air exchange and indoor air gmlity.Materials to be tmd to seat your home can include caulks,foams and other products. Primary areas for scaling inchbde air leakage to attics,bascmctits,at[uched garages and other unhealed areas(1liricb%ls are not generally - addressed.) This will require(8)1larking hours.A reduction in cubic feet per minule(crni)of air infiltration 11ill occur,but[tic aciml number ofcfm is not guaranteed. At the completion of the weatherirnt ion 1wrk,and at no additional Cost to the homeowner-a final bower door undlor combustion safety analysis mill be conducted by the sub-contractor to ensure the safety of the indoor air quality. $680.00 HAMMING:Provide tabor and materials to install it 12"layer of R-38 unfaccd MXMI EW baits to(152)square feel for dlam[ming purposes. $311.60 ATTIC FLAT:Provide tabor and materials to install a 6"layer of R-21 Class I Cellulose added to(36)square feet of open attic space. $45.36 ATTIC FLAT:Provide tabor and materials to install a 7"layer o f R-25 Class I Cellulose added to(363)sdht[rc feet of open attic space. $471.90 KNEEWALLS.Provide lalwr and materials to insiall 3.5"R-13 faced fiberglass hilt insulation to(20)square feet ofkneewall area. $26.€0 KNHWALL,'t Provide labor and materials to install 2" FSK faced semi-rigid fiberglass board inWation to(122)sgdrlre feet of kncewall area. $427.00 ATTIC ACCESS Provide laborand materials la insulate the back of(])attic Match with 2"rigid Therlanx board, 535.00 ATTIC ACC provide labor and materials to make(I) neceunpcniilg from oae attic arca to another by cuttingn passage through sheathing. This access mill be tell open as it is bcillceu i%)common wilicatcd nem lirellallcd attic areas. 531.31 A'rTlC ACCT 55:Provide labor and materials to install(I) easily moved,insulating cover for the allic access fuldingstair. A small flat surface ofplywoodwill becreated around lheopcaingWthinthe attic. This willailowthccover's integral wcather-strippinbto. restrict air leakage. $237.fi5 ', Fedoral ID#05.0406629 RISS:Engineering RI Contractor Rogislration No 8186 MACOnfractor Reglatrallon No 120979 A division of'Iltielseh l nglnccring Company Address,City,MA 00000 CONTRACT CONT ENGINEERING' f�/"AL 1 401-123-1234 FAt401-123-1234 Page 2 PROGRAM CILIA-HES ERG INEEMRINGANDIHECUDS k,O'ER&FORWORKKAS DESCRIDED SELOW CUS1W/£H PHONE DAIS CLIENTS WCRKCRD4R Alison Devita '� r Gk (978)835-3271 07/19/2016 437€64 00002 ITSSERVICE aTREET DIKING QtREE7 - 62 Meadowood Road 62 Meadowood Road if SERVICE CRY,UE1TE,YIP DILUNG CM,STAIE,ZIP i North Andover,MA 01845 North Andover,MA 01845 ;i , J€6 JOB DESCRIPTION VENTILATION.Provide labor and materials to install(1)insulated exhaust hose nilh roof mounted flapper vent-to exhadtst--- existingbathroom fan(s). S118.75 VENTILATION:Provide labor and materials to install ventilation chutes in(59)ratter bays to mainlain air Ilow. $118.00 INCEN'T'IVE:RISE Engineering Mill apply all applicable,eligible incentives to this contract. You uifl only be billed the Net amount. Currently,for eligible measures,Columbia Gas offers an inccnlivcof 75%/ not to exceed$2,000 per calendar year,and an incentive of 100%for the Air Sealing measures up to the first 5680 and an additional$340 if savings are justif icd by the auditor. FOR A LIMITED TIME:Columbia Gas%ill also offer an additional SIOD incentive touards the sxathcrimtion lwrk outlined in this proposal.This special Sunnier incentive is tivailable to horncowiels 0io have had their Columbia Gas home energy audit bafore,1uly 31,2016. A signed proposal far ucatiterixation needs to be submitted by Al gena 8,2016 and work must be compicied by&-plember 30,2016, Fort he safety arid health of your home's indoor air quality,uu W11 be conduotin&n blower door diagnostic of the available air Ilow in your home both berere the cork is licgun,and after Ilie ncatherization cork is coin plete.We Mill also conduct a full assessment of the Comtwiion safety of y our heat ing 5y51cm and water ldeatcr.This has a value or$90 and is at no cost to you. The maximum allowlile incentive for all mcasures,including air scaling.is$3,210 The Permit Mill be secured by[lie insulation contractor,at no additional cost,it is the honicolmer s responsibility to close out this permit by contacting their municipality at the completion orthisnork. $90.00 Total: $2,592.97 Program Incentive: $2,237.23 Customer Total: $365.74 WE AOR FE HEREBY TO FURNISH SERVICES•COMPLETE IN ACCORDANCE WITH ABOVE SPECIPICATIONS.FOR THE SUNT OF "*Three Hundred Fifty-Five &741100 Dollars $355.74 UPON FINALAUSPECIKIN AND APPROVAL BY AIDE£NOWECIRK CUDICY.ER Awees TO REMTAMJUNTOUE IN FUU..I41EAa9TOF 1%WILL1111 CHARGED MON'lKLY ON ANY UNPAIODALANCE AEXR 30 DAYS,SEE REVRR9E FQAV 0RVU4TINFQFaAT0N OH CUARANEES,RFGitl9 OP R£CILICN�DCH RU NRANp CtklTrtAC'PoR REOI9TRAECH. BO NOT SIGN THIS CONTRACT IF THERE ARE ANY SLA q SPACES AVnIQ660810 ISE EOCI� CUSAYSER QQ W ROTE:WIS.COMACTM\Y UE WITHDRAWN DY U9 IP NCTEXEGURO Wi711N DAIS OFACCEPTANCE --�--#AD & ACCEPWNC£WCONIRACT• CE9.9PECIFICATON3 AND CCHDRIONS ARE 30 DAYS DA'00FACWRYl0U9ANDAREHEREOYACCEPIED.YCUAREAUBIORIYPDTC001HEWDRK AS SPECIFIED,PAYNENTWIU.Q E ANDS A9 OUHINED ABOVE The Cowtmtotilveafth q "Hassachinva els 0 OUT Bosim, &M 021152017 Workers'Compensation, tMcrener•ral Blisinesses. ID HE htl,at D=111VE,111,;ttAttT9IN A.U"{°lt0t1a'11% W��WSW1 tW"tst•t"WIeW��tatW ��wt�1��.°W,��u1� «t�}�W��C:y E ta.,aaau .;/(yr ,apNrftr<ttirarNMilne:Mill City Energy..._._. . Address: PO Box 6411 Ci(y°/`t,IIe,/ iP: <arp~hc P"10r, N1-1 03108 603.3931 792 3 W yo t pan employer?r Cheek the aappr•fil�)r4tle box; oxnurse ss Qpac (r°cqnirvd): I. l care as e an�slc)r a.tr wiw - <ar�rr slc, t CS RAll told/ 5 �.j Retail l � l yv. ( 1oratelja srarlaa�c ar�tr rare^tcrr car aaartarc;rsiaa a<tracl l�aaaar�cz ra<a �' �.. �Ific.pl,�aar<aral/f3aar/C atrnf l �t�ahlisFrtaacTM,rat. C 1 I 1 1. 00% nicilor Sales(Oct teal=W,aautcr,etm) r;ntfalcay4 as wv<,aa cant,for file ire ally c ap"wily INo wcrrke s't arrnlr insurance iccluirudj El Tluul-profit 3.0 Wo aarc,a cearpa mtrtara incl Rs Micas have exct•c,ked I {l I;rrtmrrrraa:n the rrylatarf'exeraalatitsn►acre, 152,§101am!ewehave 03 f,✓Saraatlaruming I. . r�rKrccaare a num prctfitaninsurance,o wrkers'comp, Nafgzadof;�,Y:at�lw ik4 vcaltrtlrtatNrlca,rar,r 11. Nfr,.tatltlr("'are with no mriplcsyees.[No eytarkers' arra. insurance,reel.] l 7..�(�ftkae^a V�_0��1�►? .!�.. Lrty arNrrrli<aarat rNrar check's iui)x P I mkisr.al"'o lilt_ _._ ..._.._ ___. __.m 19¢Vrrr raraaaar€arca refries°rra h�ata�a^xc°r�n read I6ar:ari�clvc otIl thiaut�p,a�aaaraaae>rrataarrr faa�aa�flick a4taalar,a,„ c.arcwa ra�rau�,ataarra n>Itc r uat�raar attar �,a f f ! ¢athr a«,tarf,Icri+c a l,r tiruMt.ar, c armtra,ns.araran palac.y ry r'e,,cy�aarafcf arra„1 siada Awa rp;rarrrr;aticara kacrezle4 r,diecic box#1. sesta sera r�eae�ilarya tfiicnt r,'c�a°raa�arlrea awcawlera.m'a.�rsaivria*ia.�ratrrrai esa�eaaaiaaa�c���a�ra ray e„�aealale�t�c>r^a•. e�lteaa�i�a tlaec�xexCau,y aar�'ioeaeiaetlu�raA tntatamna e C`"mWaaray S arne (.,�h k I isurenme lnswerY ft.clrlaa s,,:One SuncliWal Avenue Site 3022 f�"lY,yd"�tralrf�il�r: C��anc;lae�a�;tc:p�, I�fi tJ:31(J1 f'c,rliasy U or° sh=ire;;. 1..,A 9_I1NlIV�4 fa91f,3r3fla _..,....1„tfairaa ion 9y;aturl/291�C117 m ea U=h as m°egy sal"the�maaarm laatr'ra" ceprarfraarsa�t'Oaaan locr�ficay ato.cl mr�Wacrra l�a� s(slrttawiea,„the poNcy rnaarrfasr°eruct c"W%chafe)i Cbiluns Na secure cacavefa ge<as re+ltaired umler Wcaicara 25A eaf mm c,. 152 c;a n lead Per flie imposition aaf eritrrinaal l:eraaalties ofa Eke rale ta�>".S'I,:SC)Vf.fltl attytt^°e�cr c>rrc,vc;aar iraagarisa aaa�aaerat,as%w11;as 001 lae•aarallbs in the Inn an e°h6M VIt")fW.K Cfltl)FR and:a fbiea of r.a1a'to S250110 a edify sas;aa ml thaw vical<ata>r. Be.aaivrwtl Umt as c`.C.al)y of Wis swimnent rnayy be l'orwarcled to the Office of _r �ra lft r acaver v rifictohcra d10 he lDcdd i, era 1rraaararat enalta rflemy thed Ilit,eair"aaraA_.) lAWCvli d above 4_!r rt:a P✓I 4o We•fQt, 1C7 2y q,' lai,craaa Ik 6030964520 C l fi iaal use aare(q> Do not write in tfta ar(,u,to her t9a mf4ele d lay eity ortown(f 4, ral. Uq or T oaaraa...........__.w.m.. .. __ ...,. .._ _t°ea°rasaW I Ac enser R, ....... laser ng r5rr4haaa~if;y(c&W tares): t.t3a>wd of HearlBar 'I Building hWep ar ferrule► I 0"k A t.,fe.eOAng ftcrMA I wda^efmareat"aa Wyfne(a f.Other _d. _..,.�..�..... �,_...�......... ...........w...�..,.,�...,....�,.., ..._.__.,...eve,av�rucrr�,�,.t,a,vfcli4p.��,....� � .,W�_�_._W.m_ �.,.�._ ..._,.._�,�..��.w.�..�. .,.,.w..._.........__, MILLCITY•1 AGOULD CERTIFICATE OF LIABILITY INSURANCE RATE{MMfpplYYYY)7!1912016 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 CONTACT NAME: Clark Insurance PHONE FAX One Sundial Ave Suite 302N _AJC.No,fit) {$03)622-2$55 �c Na;{603y 622-2854 Manchester,NH 03102 a DRESS:agould@clarkinsurance.com INSURER(S)AFFORDING COVERAGE ____ MAIC_ INSURER A:Arbella Mutual Insurance Co 17000 INSURED INSURERB:AmGuard Ins co 43290 Mill City Energy INSURERC: 106 Joseph St _.__.._._. PO Box 6411 INSURER 0: 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. INSRTYPE OF INSURANCE Al7D smR PbL1CY EI:P POLICY EXP LIMITS LTR INSD D POLICYNUMBER MMIDD MMOD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 8500065735 0412912096 0412812017 PAMAGE TO R REMISES 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 POLICY❑PJECTRO 1:1 LOC PRODUCTS-COMPIOPAGO $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 Ea accident > > AX ANY AUTO 1020050919 04/29/2016 0412912017 BODILY INJURY(Per person) $BO0DIL ..� ALL OWNED SCHEDULED - .,I-L..Y...,...,.. .RY.._—........__-� AUTOS AUTOS INJUU (Per accident) $ X �( NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LEAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE 4600065736 0412912016 0412912017 AGGREGATE $ 1,000,000 DED X I RETENTION$ 10,000 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY .-STATUTE.., ER B 1 ANY PROPRiETOR1PARTNERIEXECUTIVE MIWC791896 0412912016 0412912017 E,L.EACH ACCIDENT $ 500,000 OFFICERIMEMSEREXCLUDED? ® NIA ---------'---- (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/LOCATIONS I VEHICLES (ACORO 101,Additional Remarks Schedule,may ba 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 61845 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Masswhusetts DePartirient of Pubhc Satety Ca7rIM(U(JrO1 Suj)eIViS01' Board of Brading F"teiplations and Standard" Restricted to: Unre.strruter Build¢n3s of aany rase group which contain License: CS-110041 less than 35,000 cubic feet(991 cubic metms)of �,,'onstruvlmn Sup(,.,rvmor enclosed space MICHAEL JOY '106 JOSEPH STREET MANCHESTER NH 03102 ., F aliur'es to Possess a current edition of the MsassAchusetls D'— - is,xPirafion: Stato BiAldirg Code it cause for revocation of this license. eammussioner 08/0712019 DPS Licensing information visitc V4WW.MASS,GWDPS aafr"Ger of t r �us� �u 4ii aievF<� i3rpwnd�r�as ie�G,�ar airara fire^rtR orn"e�gi,�rrbr)parrr wahcN fornrrkii 610rr�i^"10y ion rr � a awQrsCsaue" r fit» iylma°"` )t0 i°�uriail�ivar�anr°mrvr ffah ii faanrrrf rr°Giarar Cors tiOMi ri"�f ROVE Mi f1r"i.mr?6^di9a�,. ;'`"iCaR err rias a^n 3Y3 3. rrrnisr ,fish" and 33iiwirre o,itegolra0wf t.° garu3ir)ra. 7f,r'70011 L �3 t 3(i go,,gom NIA 02116 W i n"iii 1 L rXIF',3"1 IIG MIGHAFL JOY Gray, I�»P i`64,„ar83i � N" iarwrMrtr�r�" r'+r' Pa9asr(I'Hk,S L,14,iii1 03 02 11=u�i0 waiRi�reaiaa,i fnl�arrrr