HomeMy WebLinkAboutBuilding Permit # 10/28/2016 BUILDING PERMIT �oRr OF,�Ttea rb'gsy TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION � r a Permit No#; Date Received SSRCi 111`r� Date Issued: O moi IMPORTANT:Applicant must com fete all items on this page LOCATION 2-1 SQr Arm Print PROPERTY OWNER en"L rLd Print 900 Year Structure yes Cno MAP 0 PARCEL: 00ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non-- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial ;KRepair, replacement - ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other � �,. � .✓, >`J "�,"^ y � ;:. �C`.'.; .� Ai�*.��s'.�T� ;�.,� F" c.:m ..q; ,,..�,�w=z '-' a -.� � :;�y;,:���r'"�` � ,. '�.wN�,. ;, .� ':= 5::�r -r;,,�„^ 7 Ulla ershed Wetlands DESCRIPTION OF WORK TO BE PERFORMED: Gti r otam rn &. &*h*c. bacK oF a ;. raccces VF bACK og 64ZMA4 Avoy tea Identification- Please Type or Print Clearly OWNER: Name: Eric 7"uLgfj n Phone: 45 -z Address: 21 S xucA- Nn do MA 6 jLi Contractor Name: µi :SoM Phone: 5a 3 2.- 20 -t Email: 10 W a m Address: Go41, M& oatolt Supervisor's Construction License: 11c C*41 Exp. Date: 7 2010, Home Improvement License: lqq2 Exp. Date: -712'7 / 2ot2______ 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: $ 2 S(o I. 2(. FEE: $ Check No.: 3 Receipt No.: 3 __ NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund r ............................................................. IAORTil t Town of a t, 6 n over • Z MJ.i..-M *xt 0 No. 45 0 44 - - (7b 4 �O LAHE h ver, Mass, _� ` 21 n AN 6 CGCM1C ME w.[K R' U BOARD OF HEALTH Food/Kitchen Septic System PERM T. T LD THIS CERTIFIES THAT BUILDING INSPECTOR has permission to erect .......................... buildings on ........... .......,��,& le Foundation ''..��ww IRo",1 to be occupied as ........1R,NL. .`.�:° . .!'......,, t I ■„ II► /nform � � � ................ Chimney provided that the person accepting this permit shall in every respect c 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 y ® Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRUCTI START Rough ......... ................. Service Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building 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. �f f RISE60 Shawmut Road, Unit 21 Canton, MA 020211339-502-6335 ENGINEERING www.RISEengineering.com OWNER AUTHORIZATION FORM (Owneame) owner of the property located at: (Property Address) IV v' G a i'!i'�C^Ir L� (Property Address) hereby authorize ..-k-(SubctracU 1 CA"+m 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. ' e54,4i, S. i ©wn is Signature Date Federal It)d 08-0406826 RISE Engineering RI Contractor Registration No 8186 MAContractor Registration No 120978 A dhisiun orThielseh Engineering 60 Sbawmut Rond,Canton,NIA,82021 ENGINEERING' 334-502-6335 FJLX339-502.6345 COWRACT Page 1 t PROGRAM WIT!,i" Ch1A-Hi.S r Cm"ff1,0aA�Ct13MN Ftp " krS Lt Imm t G7 PHME DAM CtietifA WCRiC ORDER Eric Tull ren 5- C%J (978)688 92 0810$/2016 438411 0000? l SUVICB SIM= ;: f A SIuma amaT ?)Spruce Street 4 21 Spruce Street c7 smvres cmrW-i-x ;�` J } Q mwrto cttr,B1A1r94zw North Andover.MA f7>&3$ l North Andover.MA 01845 JOB DESCRIMODN HEALTH&SAFET Y: Have your heating system tuned up and retested to be sure that the undiluted Rue sasses do not exceed 100 parts per million(ppm)carbon monoxide.Weatherization cork cannot proceed wail this is Reed, $O.OD BARRI Elt:We have discovered what appears to be a mold/mildew likz substance in your home,This is being brought to Your attention to identity it as a pre-existingeondition to the insulation and air sealing murk planned for your home.Your sipature is your acknowlcdFment of these conditions and agreement to proceed SEB PICTURES. $D.UO AIR SEALING:Provide labor and materials to scat areas of your hnmc against Surstefal.excess air leakage. This stork Nvill be performed in concert with the use of special tools and diagnostic tests to assure that your home will bd lett with a healthful level or air exchange and indoor air quality.Materials to be used to setts your home can include caulks,foams and other products. Primary areas for sealing include air leakage to attics.basements,attached pprages and Other unheated areas(windh%vs are not generally addressed.) This will require(8)workinghours.A reduction in cubic feet per minute(efm)of air infiltration will occur.but the actual num berofcfm isnot guaranteed At the eomplction of the meathedzation twrk.and at no additional cast to the homeowner.a final blomcr door and/or combustion safety analysis Mill be conducted by the subcontractor to ensure the safety of the indoor air quality. $680.00 MILDEW IN 13ASEMENT ON FOUNDATION WALLS,301 STS IN ATTIC ON RAFT ERS AND GABLE END.SEE PICTURES. $0.00 DAMMING:Provide labor and materials to install a 12"layer or R-38 unlaced fiberglass batts to(7 1)square feet for damming purposes. $145.55 ATTIC FLAT:Provide labor and materials to install a 6"layer of R-21 Gass i Cellulose added to(784)square feet of open attic space. $987.84 STORAGE HAM FR:Homeowner is responsible for the removal or the stored items block Ing the installation of meat herizaiion wrk in the attic, Removal must occur prior to the scheduled work start.«initial» 50.00 AT'f IC ACCESS:Provide labor and materials to install(1)easily removed Thermal Tent cover for the attic access folding stair. The cover has integral weatherstripping to restrict air leakage.Width:22"or r5"(circle one). $22&65 VENTILATION:Provide labor and materials to Install ventilation chutes in(64)rafter bays to maintain air flow. $[38.00 BASEMENTCEILING Provide labor and materials to install(132)linear feet of R l9 unfaced fiberglass insulation to the perimeter of the basement eetlingat the house sill. 5231.00 Federal ID#116.9495929 RISE Engineering RI Contractor Registration No 8486 MAContractor Registration No 1211978 A d1l0s1on of Thlclsch Engineering RISE. 60 Shanmut Road,Canton,NLA 02021T V L INEERING 339-502-6335 6A.1;339-502-6335 CONTRAC page 2 PROGRAM W 40M OTM CHISM INT$8E'ONEEN RWE CMA-FES WONEEIIso°aeKDIMcosxraIRFanwawtAS DaeGfunCu8'IDhUR PHONE DAM CUBMTa WORMORDett Eric Tuligren (978)688.6582 08/08/2016 438411 00002 86RVtCa SIRANT MWNG STMT 21 Spruce Street 21 Spruce Street BeRVtCa 0W.89U9,aP GILUNG CRY.alkil,aP North Andover,MA 01845 North Andover,MA 01845 JOB DESCRIPTION BASEMENT DOOR;Provide labor and materials to insulate the back of the basement door leading to the bulkhead with 2'rigid board that meets tho sections R-316.5.4 and 316.6 requirements of building code. Seal all edges and scams with FSK tape. $72.22 l?4CENT I VE:RISE Engineering ails apply all applicable,eligible incentives to this enntract, You will only be billed the Net amount. Currently.for eligible locasuros.Columbia Gas offers an incentiveor 754'x,not to exceed$2,000 per calendar year.and an incentive of 100°x6 for the Air Sealing measures up to S 1.020 FOR A LIMITED TIME;Columbia Gas will also offer an additional$100 incentive towards the weathedution cork outlined in this proposal.This special Summer Incentive is available to homeowners who have:had their CoEambia Gas home energy audit before Aust 31,2016. A signed proposal for wealiterization needs to be submitted by September 9,2016 and work trust be completed by September 30,2016. For the safety and health of your home's indoor air quality,%%e will be conducting a blower door diagnostic of the available air flow in your home both before the uork is begun,and after the%catherization cork is complete.We will also conduct a Adi assessment of the combusiion safety of your beating system and%ater heater.This has a value of$90 and is at no cast to you. The maximuan allo%able incentive for all measures.including air sealing,is 53.210 T he Permit will be secured by the insulation contractor,at no additional cost.It is the homeomces responsibility to close out this permit by contacting their municipality at ilia completion of this work. $90.00 Total: $2,661.28 Program Incentive: $2,219.45 Customer Total: $347.89 WEAGREEHEREBYTOFUnHt9HSERV088-Ct1kA MISENACCOMANCEWFTHABOVE SPECiRCAUM&FOR THE BUM DF *"Three Hundred Forty-Seven&811100DOW m $347.61 t"M RNAL INSFEOW AND APPROVAL BY RISE aNWMEfM CUSTONBR AWAM 1PAMAMO tour WPAL UnEMSTOF1%WD.Laeauumo RRfran.YDNAMY UWAIDBALANP,IAFUQDAYLS92MIjMlKPQRUgPMIAWOMMIOUGH QUA M 68,%amOFW.C1819N.SOMM 1te0,ANDCOMCWRREGM1RAIM. 00 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES A starve Elginear evow HR AP>ANcs NUrE:W% OYMY ft WWORAWN BY U8 IFNWEXUWMDUMN DARDFACCEPMUME '-•-�� -- -- - - .. ACD8 IPMEOFCDNTrM-VM ABOVE F1WE8 BPRCIfteAlIONSANDCWMDWARE 3Q DAYS. A8.SBP9CtRE6DPAY MrWN�.LB9AbhDfiA CUa1NDABDOEAU1[OR=01CD01lBWCRN q u�4VI (Attrw�l"'&*.�',�a �a�iv e+lp �Ytrite 10 Won, AM 021100017 V h NOR b �dr���nm � ti,'« lA /ICR IVorker•s,("ra upensMion Insrurrume At'1'Mtar M 1_Ataaa M BMrrwr easM ID HE MLED WFIMT11F, ttrtmtltttlt "jaea�^ tttt � ":.�°fit➢����'� ��I "w��� �e... .._w..._.�.,�. � �.�w� _.._ ...�.�..�,_...__._�_ _......w. �r"�rrrr,;er/(fir°yrs rrr a�icrrr h rrr r,:Mill fixity E ric, l Address:PC) Box 6411 "r pNtl 03108 ._._� _w..._... Auv you an empplapyata r Meek the atplra•a pr inta,box: BuMtre s"a Il pep('rcqmalm d): I ..✓ l arn'r a.employer with12, cmpployees(full and/ `b. E�I ltcpr.aril or Pat rrnrcl 1 partnership 1, �. (7r11'iraarrnr(d rar �w rlerpr �y1 st�rCplrslraraa°art employees,a�r4>lr r r alrrrars��l�r:pg urpr rtnershirpl��p<�lrlhave no ' a ne1L ra,�� st,-oe,arrr<p,arc:.} or parrrrar„", I to � 1 al s.,, 1 .y ;1. (lrrrr ar'criwt [No workers'conrpp.insumao,reelarrrod] E 3. 't'a'ep arev a corpporaalitnr.rant A tat"lr er.a laawo Merc,i;aeacl ry. .l I°;rrtc,rtawirrraac.rrt their right or eexrerrapHota per c. 152, §10 1 arae we heave I M J Mrallrct:rarinp„ arra eerrrpa op r s. [No worker comp. insnrance reclrrrre dj* I I.0 Health Parc„ ._41.__,.._.... "carc rrr- rrlrth volunteers, with no cnlaloycesj r>workeis romp. insuranceaar12j)6 __...,m.... ( rlcr �rlrry rapa�afo¢�rtrar trust e.{t<�:1;^.lair Pri mdr i;alt.<a rirr crirr Iltrs accdtuta P,r;rrr�,v irera+r��ry;rrrr a e^.<rcB<i:� �.cpt�rrrr�rr rtttrrar irralu, irrrrr°in€drr rrr. 66�irt�s ruo raerrtstc;aarrtrcdv;,rear a K,r�fotrrprr�r area raw>�^Ives„rra�t rlras ca>rprrru'r�rs�rra Irrz s r�trrer¢rrurpirky�e s,,rr aaurV,Qrur�'riurTr�i��atrari�ara y`xr6ro y�s rs5�trrruci arae�turaa�:arr rrrre�rrir�rtrrra sraeprrlrq rl�r,^ck i'arars�l. C re, ear•threat r.w• aa�apurtatara k parna�ur.a;w•W rarawr as=ca.�crrarpra CaaraTw°rraar°� rrr raa m��.. .w_ .._ �._,. �.,.� __".,.� ��....._.. �near rear cera a.0 p_.. �_. ._ � �-....... � �� 1" :�a�rfs/nyrres. tfrslarrse rw spar.pparlrawq�rrl�raraarrattrrar. Gursrrr�rrre,rat.:'tarptppurrry" rare. fi^I Y6c. Irty�. --- artep hi,sun is datre s:Orre urrdial Avenue S Uile 3021` City/swtr./Zipp itrrrclsr:alesr, l^Il-I 031,10,2 Y _ 1i 301117 1'G�a1ie; dP rpr;;ewlf=rrrs. I11/UC�,7 31c3� d,xp�pirtar.icprr llatcr.: a rt.Uarcla a copy He garage(showing the pmINy^rrramhu and rxprlMinn datc). Fakurw to s,.,currpCoverage as rrarlraired rrratker Section 25A of MCii_,u. 152 can lead to Mas,hnpaepsir"on C'r9"r.,rindnail 1pe..nrrllics of ar fine Tapp to$l§00.00 strutlor cpm. )mar iarapr"psrrrarmerat,as well as ctivif N^nAiaes 0 flare Ikea n sa"SOUP WORK ORDER erne)sa fhue of up to;Fa`ifl.11f7 ar clay agahm the viraltrlm% Base,advised ureal a carrpoy o t.lriw suen'rrrni may be ltrrawarded to the Office of Investigations of,11ar ;the DIA verilic ora raa t edu 1ae.r'a�t'w r:^a�aC� rt,rar 1� rw'rum d�pr�aarrArra.t at�'�pr^duCy that tla(P�aq.�rra°mraaaleon trw�arraded above ew true lrrr lam M 1603 S964620 (V,ficiol use ony. 0a not Me in thk nave,tar be a<orayrMI kv arty or town eWia:M. cigor`Ibwwxn: ....._...,__. _,.... .. ...... .......... ..... a..__ lbw rrnitCl,,are;rr e 0 lwsreairapt. artilaaarlly^(e°rreW nano: L I'hn”of""HI y;. Brailaling pyaaprar0wrami I f.:;iW ua%,n t,'tcerh f.l.,irvuslaal:,tomes 5melect"mere"s OMICQ 6.MCI, i'::'rrrrlrac.t paa,rwa)rrs.... .......... _... . _ _._ .. . ._ Phone tR_._, weaw,raaer,.,r,trefcrirr "1 MILLCITY-1 AGOULD .4►CORIv CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY) `—� 7/19121s1zo1s 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 _ Clark Insurance NAME: PHONE - FAX One Sundial Ave Suite 302N -PHONE _Ext): )622-2855 �fAIC,Nn): (603)622-2854 __.._._ Manchester,NH 03102 E-MAIL agould@clarkinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL# INSURERA:Arbella Mutual Insurance Co 17000 INSURED INSURER B:AmGuard Ins co 43290 Mill City Energy INSURER C: 06 Joseph St �.._ PO Box 6411 INSURER D: - -- Manchester,NH 03102 INSURERE: 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 ISSUER 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 ADD SUBR _,_._._.........--POLICY EFF` -POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIQQ MMIDQ LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 Of�AAG ,......_,._ CLAIMS-MADE X OCCUR 8500065735 04129/2016 0412912017 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 —... ....... POLICY jE 0 1:1 LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: �..._,...._.._.,...__-._,_. $ _ AUTOMOBILE LIA131LITY COMBINED SINGLE LIMIT $ 1000000 Ea accident s r A X ANY AUTO 1020050919 04/29/2016 04129/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAR CLAIMS-MADE 4600065736 04129/2016 04/2912017 AGGREGATE $ 1,000,000 ....��DED 1 X I RETENTLON$ 10,000 --$..-.-------- WORKERS COMPENSATION XSTATUTE.. ETH AND EMPLOYERS'LIABILITY ..-....._.... .,____._,. B ANY PROPRIETORIPARTNERIEXECUTIVE YIN MIWC791896 04129/2016 0412912017 E.L,EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? NIA ----------- (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,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 ©19✓88-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts, Department rrt Public Safety C;unstrualiort ,,upervisnr. .�.__.... .� Board of BuMing Regulations and Standards Restrictrad'to Unee sh se,tecl Buildsruls eel any use group vtticsh contain U,ceense: G,-110041 less than 35,000 cubic feet(991 cubic milers)of Construct= sup errrm orr y enclosed loske.d t pace, MICHAEL JOY 1116 JOSEPIi STREET' MANCHESTER NW 03102 Failure to possess a current sedition at than Massachusetts " W Ex pa rap'po n, Sl rte ttu'il+tiry Code is cause for revocation of tills ljcejjse. C orsernissioncr 08107/2019 OPS Licermintl information visit: ,MASS.C3'6Vi[)F"S 0 111¢s[ata ewa5urearrr AflrlrI&MRrrs6larm�tkw eel rY rr lis° bt r a��°ro"ktr m°aai wad valid t'w"old k Brat low 0,110y t90Mt;PCPPC) &4s F"Ni W CCNt"11ACTOR to afmga torr ektrirart9«:wrc 1»erk°, lftarerrrp rc^Isar a ear: �1 tYfliec rut toll's erner yAffaair%san4 Sershwk%r� Regulsatun t irm rl � r�askPttirrru182Mi.yp��S: � �' �fapeir`s.arare: e1�"sa td L..'' W Park Vlar�A su11r„5170 f3fptree's,Nft x 021'f6 NVI11 lsVt�tlapmfir,r W � Motl4;1-fiA L JOY MdlANCH `rotLR,tH0s'402 �Warw1rrwraresrr;p rT rAik sAhmlt,4(Mr Yurtt