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HomeMy WebLinkAboutBuilding Permit # 12/21/2016 Npf2Ty BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION p N Permit No#: Date Received �qSS Sreu �5��5 A4CHt1 Date Issued: ✓ 'l I IMPORTANT: Applicant must complete all items on this page LOCATION LI{a LACOiz c'c-- AroL Print PROPERTY OWNERS Prin# 100 Year Structure yes. no MAP�_PARCEL: . ZONING DISTRICT Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial XRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other -•� �Wtla ds � f ,V �tersed :gtrE � u. DESCRIPTION OF WORK TO BE PERFORMED: air -Q a.,Un insu.lof �: kc._Common wa#s. ;5kirwrfJ ins&ll inswland Uh&C5i� ho-,e- h W&I Irl Identification- Please Type or Print Clearly OWNER: Name: ShcLng . W vdrug- Phone: L--5D4 wA—Z-7,7 Address: I L6 L '0,,- Cir 13OY44,- And qvt,�,i HA 4 S Contractor Name: o Phone: 38z- Email: R140) •ilAM Address: Tb`fix' &-ju :,AkIuAlri W 0316$ Supervisor's Construction License 110041 Exp. Date: ....Home Improvement Improvement License: I t 2-742 Exp: Date: -71. 2-7/7-00 . ARCH ITECTIENGINEER Phone: Address: Reg. No. FPB'SCHEDULE:BULDING PERMIT:$1200 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ��, G`75. �� FEE: $ Check No.: Receipt No.: t NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund r ... . __ .... . .. r:. �„ . mow.. .�,.. ................................................ .......... ....................­­­"'­"­.............11....................I............................ ............... ............................... T t%ORT#1 own of n over' . No. ver, Mass, 42,1 2,b o KI -- co'c"Ic"[W BOARD OF HEALTH PERMIT T Food/Kitchen 0" D Septic System THIS CERTIFIES THAT , BUILDING INSPECTOR ........................................ ................................................. has permission to erect............ ............. buildings on ... Foundation o X, Rough to be occupied as _.. I .. 'S - ` .. ......i...... .................. ................. Aa)r.- C.- Chimney provided that the person accepting this permit s 11 in every respect conform to the terms of the application Final on file in this office, and to the provisions of the odes 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU S A Rough Service UP ........... .. BUILDIN.G.INSPECTO.R Final GAS INSPECTOR Occupanc Permit Required to Occup-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. RISE 60 Shawrnut Road, Unit 2 Canton, MA 02021 1339-502-6335-1 ENGINEERING www.RISEengineering.com OWNER AUTHORIZATION Shane Woodruff (Owner's Name) owner of the property located at: 63 Laconia Court, N. Andover MA (Property Address) (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. Owner's Signature L, & Date i ttC 0 � Federal ID;'t 06.0405629 RISE Engineering RI Contractor Registration No 61186 MA Contractor Registration No 120979 CT Contractor Registration No 620120 RISE ENGINEERING" bll tilwirvnuN4lioad; 117r�' CONTRACT l?2UZa 339-50'-1Csi19111 Page 1 r PROGRAM '} r It •} - X9('1'111 ? THISCONTRACTlS ENTERED INTODETwEEN RISE I€ t � I - }k i •E CMA-"FS ENGINEERINO AND TnE CUSTOMER FOR WORK AS DESCRIBED BELOW ...:PRONE DATE CLIENTH WORKORDER Sham:WOOdrtitf (508)631-2767 11/14/2016 441984 28602 SERVICE STREET BILLING STREET 163 Laconia Court 163 Laconia Court SERVICE CITYr$TATE,ZIP rrrr� BILLING CITY,STATE,ZIP North Andover, MA 01845 North Andover, MA 01845 JOB DESCRIPTION Alit SEALING!Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be perfimnel in enneert with(lie use of special tools and diagnostic tells to assure that your[ionic Will be let)with a healthful level of air mirange and indoor air finality.Materials to be used to seat your hoose can include caulks,Foams and other products. Primary areas far sealing include air leakage to attics,basemteris,attached garages and ollier amheated arcus(windows are not generally addressed.) This will require(12) working hours.A reduction ill cubic feet per nlinule(Clin)of air infiltration will occur,bill t€le achlat naunbcr of cl'ni is not guarurtced. At the completion of tliC 15'C111hertLnboti Work,and tit Ili)additional Cost to the home'ow'ner,It final blower door amilor combustion salbty anulysis will be conducted by Ibc sub-contrac(or to ensure the sa(ety ofthe indoor air quality. $1,020.00 ATTIC FLAT:Provide labor and materials to install all 8"layer of R-25 Class I Cellulose added to(f 140)square feet of tloored attic space. X $2,05522.00 Al 11C ACCESS:provide labor and nniterlals 10 insnllile the back of Elie attic door with 2"rigid insulation board and seiil the door's edge %villi weathersiripping to restrict air leakage. $73.91 V1 NTILATION:Provide labor and materials to inslull(1)insulated exhaust hose with roof nlounled flapper vent to exhaust existing bathrooms fan(s).Broan model}1636 or equivalent. ly $118.75 COMMON WALLS:Provide Inbor laid materials to install 2"FSK faced semi-rigid fiberglass board insulation to(156)square feel of common tall urea. $546.00 STAIRWELL:Provide labor and materials to install class I Cellulose insulation to the sheetrock or plaster ceiling and/or walls of a slairwell which are common to heated space,through a surlacc drill and plug method, The holes are plugged with styrofoam plugs,and spackled to a rough finish. Any sanding and painting required tire the cus(omer's responsibility. Homeowner bas received a copy of the LTA's Renovate Right Lead•Snfe infiormalion guide expla€ning tile potential risk of the Iead hazard exposure from the weatherization work to be perlbt7med. Your signature is your acknowedgement of receipt and agreement to proceed. $175.00 P 1 RISE Engineering Federal ID#05.0406629 Rf Contractor Registration No 6106 MA Contractor Registration No 120979 CT Contractor Registration No 620120 R INEERING" GO Sbowmut Mond,Conten,RIA 112021 CONTRACT 339-501-5197 I'AY 33'1.502-6345 Page 2 PROGRAM THIS CONTRACT IS ENT�REI)InTo ETWEEN RISE CMA-HES ENG€NEERINO AND THE CUSTOMER©OR WORK AS DESCRIBED BELOW CUSTOMER PHONE DATE CLIENT# Shane Woodt•ttff WORK ORDER (508)63 1-2767 11/14/2016 441984 28602 sERVICE SIREEr BILLING STREET 163 Laconia Cotnt 163 Laconia Could NPRWCE CITY,STATE.ZIP DILLENG CITY,STATE,ZIP North Andover,MA 01845 North Andover,MAO 1845 MOSS DESCRIPTION RISC Cnginecrillb will apply all applicnblc,eligible i€tccnlives to this contract. You will only be biticd IUB Net amount. Currently,IDr dig We mea ores,Columbia Gas offiers 75%incentive,not to exceed$2,000 per calendar yCIIT,and all€ncenllve of-1 Oil%for the Ah'ScaINIg mets"res up to lite first$680 and an additional$3'10 il's€rviu;s are juslifie[i by the auditor, For lite salety and health ol'your],Dole's indoor air quality,we will be Conducting a blower door dlabllostic O 1110 available air flow in your 110,110 both b0bre the work IS begun,and after Ih0 Vveatherization work is complete,We will also CnndElCt ii rIlI1 a5SC55111CBt ortile cor,lbusdon sanely or your Ite€ning system and water benEer.ibis has,a VIILEC Of$90 and IS at uo Cost to you. "I Olaf allowable weall€erization btcentive is$3,110, The l'crinit will be secured by 1110 i,lsal,'lfion conlruefor,at no addiliollal cost.It is the homeowner's responsibility E0 CIOSC o,Et t1N5 pl'Tlllfl b)'COI1laCllllg 1t1C1r mtnllCtpnhty ill 1hC Cornplel IDN or t1115 SYDrI, $90.00 t . Total: $4,075.66 Program Incentive: $3,110,00 Customer Total: $965.66 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Nine Hundred Sixty-Five&661900 Dollars $965.66 UPON F1 NAL SP CTION NO APPROVAL BY RISE ENGINEERING.CUSTOMER AGREE$TOREMIT AMOUNT DUE IN FULL.INTERESt OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID GALA CE E 0DAYS,SEE NEVERSE FOR VAPORTANT INFORMATION 017 GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. i AUTHORIZEO SIGNATURE•RISE Englncening CUl3.T -ACCEPTANCE NOTE:THIS CONTRACT MAY UE WITHDRAWN BY US IF NOT EXECUTED WITHIN / p GATE pF ACCEPTANCE 30 ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE DAYS, SATISFACTORY TO US AND ARE IIERE RY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED,PAYMENT WILL BE MADE AS OUTLINED A13OVE The(";'oinatrantrxeeifth ql'Museicseltv Deparitneiet 10 8eivion, AIA 02,114,2017 wR i 1, "pwrorinen•rr'" C,outpenswHon Insurance t` f ionvit:General Busnna sraaN. j To BE ta6t,t~'.3)y3I"t'll'I'ttt?t°9a3VOI'C"C"ING Aq1"t"IICPtt.ITN". f ttsfltr < d(w3t°g trrti'.<tliayrr ttrnc:ITCH City ane y PO Box 641.1 `anrlisler^ NVI 03,108 603-391-7923 Are you an enrplr:ayeu!Cheek Me approparirata box: H uM ncss"t.ylpc (raquked): 1 r I artn a ernaploy car ns 9th 1,2 rent sloe ee' (full rand/ "' El 1CctO laanaaa strlcc ser Gr, gCcstraarrauClp4tnk atinpl,@ ¢ats(aclrrntcrrt n �.gym, p sla ictor°or pan ners,hip arts!have no 7. El Orike and/oa,,"^,ahs(incl. renal es,traq caum,am) employe'e's working,R)r ule in any Capacity, �V°'s"o workers;' corirp. insw arnce requiredl IS. Nann-1 rof`it I[,j We rtru aa.corporation anal its officers have,ex ercatred 9. �. � 6 rateraairrnrerut I 1 .a ( I }. ._. Weir rir;;pat o(`exemption per c. I`��".,m�1 ^��t'),rrraal a�✓c".have murrra1<arrtn.rr'inp, no m'ruployc es. [No avorkets'comp insurance retpuur clj*s '&.El wo ars a non-prolit orp�anizatiora, Mtti^a al by nrolnn[e+r I? 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Inrarrar°car"s Ar3clrass:One Sundial AveMie Sraila, 302N C1it.yl`P,ttc ;ip'a: ldatr, lel°I 03102 111 Polky A or WIons, l,ic.gy13MIVVC 91 t39(a .w w....._...,C arpuirsatiorr Date,4/29/2017 rad raell«a Copy of'tlae su^aas�lctar`s' raanaapaenrsatir�rnx p�noMda.y a�lcc�la��aratua,n la uta (wlntnwiwap,Me poky number and a.sp,an,rantnceanr alate). Failure to secure coverage rrG rt ruined unkr Scohn?"ark of iw+lCH,c.,. 152 can lead to To irnposkion oraurninal perraldes ofa tine up to$1,500.00 and/or ore-y ear^imprisonnwnt,as v.a 1 as c iAl p ensurl(W irn he t"t)rnn ora"1"�l'c:P`whit', HC (y6tT)ER and a f"Irma: (A'up to$2501H)1H)ra dray against the Walon Be rrtiviW rlrw ra vVy carMN stratenranent may be R warx.led to the t)rfiec,of Investigations ol'thee DIA for inset ane coverage,Verification. _1 eCra/tart x9199 r a:°a s"'qp�,car 711, I,P rerr,e�amPrcl r raamdPma w art"pr�r jrarj,thtit the 1Pp,prawinaaliou pro tli lr a(arbotic r.a+�fru e and corred. �"rif;rl.r3rrrE.,...,......w.._ _.......... .... .. ... :_....rv._._ _..._,....._,... _,w. ._..... ..._ ....._m._...,..,„....._.... ..._____L.Ptl4'y.. _�.� I�-.t..j.�:...��.� ,.,,.,.__,.._.__..,_._._..,.__....,_,... Ile,Ih iclta I.",a�(J . aa.aarl araar arra(,�....lyar arar,Pros,rada�art Plmrs arer°a.arm Par lar.a:r�rra BaYPr^al Faya ally a �.��.._._.. .. .._ I'a^n°naltlh,arcnsca.ll C':'ity err'"i'raswna:_..__ __.._......._w ............ ......... . _.._.___-__.. _ ..... ........._......,... _ ..,. .... ...... larsnlnp Authm iOy (6rcle one): 3. How or 33ernith 2,Building,Departmeni :3.C:ityl.,p owvrn(Aerk 'L Ucensi"g Board 5,Seleetwewn°,.Offive da.0I her C`a>d aeI Pers nn..... ...._ MILLCITY-1 AGOULD A�CORO DATE(MM101111YYYY) CERTIFICATE OF LIABILITY INSURANCE 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 tenns 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#AOR8150 NAME CT Clark insurance PHONE gQ3 622-2$55 FAX One Sundial Ave Suite 302N jc!�n,.Wj_(..__ ) Arc No): (603)622-2054 Manchester,NH 03102 ADDRRESS:agould@clarkinsurance.com INSURERS)AFFORDING COVERAGE NAIC# INSURER A.Arbella Mutual Insurance Co 17000 –....._..,._.... — -- -- -- INSURED INSURER a:Am Guard Ins co 43290 Mill City Energy EnerINSURER 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. !LTR –TYPE OF INSURANCE S R POLICY EFF POLICY 6XP LIMITS S 0 POLICY NUMBER MMIOb MM1Db A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AMAG TO RENTE CLAIMS-MADE X OCCUR 8500065735 0412912016 0412912017 RREAt(SES-,(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 11 JEST1:1 LOG PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: I I I $ AUTOMOBILE LIABILITY EaCOMBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO 1020050919 04129/2016 0412912017 BODILY INJURY(Per person) $ ALL AWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X AUTOS NED PROPERTY DAMAGE $ AUTOS (Peraccident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE 4600065736 0412912016 04/2912017 AGGREGATE $ 1,000,000 DED I X RETENTION$ 10,000 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETORIPARTNERIEXECUTIVE Y 1 N MIWC791896 0412912016 0412912017 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMOER EXCLUDED? N 1 A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE! $ 500,000 Iryes,desuibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS r VEHICLES (ACORD 101,Addittonal 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 01645 AUTHORIZED REPRESENTATIVE O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD ----------- Massachusetts _ settnao;�of C rtlc rvCtfe'ff__.... t )t4t ttCal(r Supervisor tSerVii)r Board or Building R gnalkns and st nd'ards Restricted to Unrestricted BUiltltars O _f.._any _r—ise group which contain B_ enasc. CS-110041 less than 35,000 cubic feat(911 cubic meters)of (-'ons trur,tiok ` upervmor enclosed space, MICHAEL JOY ;���'„ '106 JOSEPH STREET MANCHESTER NH 03102 Failures to possess a c.urrerat edition of the Massachusetts . i r atiorro: State flrailctir(f Ca>rfe is caara,ar for revoc atiuu of t1at5 liceal� .. Commissioner 0810712818 Of'S Licensing iraft'ioro s¢tion visits V9ild'+/6"r1.MASS.I OVII)'S i t 01114e�of owmirsrr 'tfGora�6, trad�vw,,nrg akfio a 1 irvra�a of rer. "str€atirran vaIi f for insiacitItI nstr orliy r tlfiMlf liWl{I Q1Vi M"6CNi ICON � t7't"f td bvfuvcc(1w e'&auha6'ml&WIC. If tiaauaat arinrn to s st0liaana; r �' ara; Ofiiee off othume r Affairs and Rosiness Rgoiltetiarn i t1 d t Pi 15T 71' t v .staaa`nticaaa° 1 It 'tT t,�,r,b 10 Park 111",a Suite„1"70 Bomar,ral,t 02116 ?A4 1 K; Y i,KtaR(31( 11(", pA4 HAf k. .}n:aq' „ � m 1CIr MAiin.:;tIf": ER,tlfiPYhRs7d t raelwa� awrrae tia a�it atlrnaui si ��nrr'^ 1 1