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Home My WebLink AboutBuilding Permit #340-15 - 11 APPLETON STREET 10/7/2014 NORTFI BUILDING PERMIT 6".+ TOWN OF NORTH ANDOVER - APPLICATION FOR PLAN EXAMINATION * - ry Rec0- eived Date Permit No#: gSSACHUs�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �. ff PROPERTY OWNER�/TC) Print/t //Y Print 1 o0 Year Structure y� no MAPPARCEL:-6kZONING DISTRLCT: Historic Distract es no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Reside Non- Residential ❑ New Building ?'6ne family ❑Addition ❑Two or more family ❑ Industrial ❑AI ation No. of units: ❑ Commercial epair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District Q Water/Sewer DESCRIPTION OF WO K TO BE PERFORMED' U ,� ��% .010aL.ofyr i gzt cru 14 ®� S S � jdentificPn Ple s pe or Print Clear OWNER: Name: Phone: Address: r� D Contractor Na Phone: - U� Address:_ 1!8: Supervisor's Construction License: Exp. Date: o Z�7 Home Im rovement License: l 7 Exp. Date:. ARCHITECT/ENGINEER 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: $ � 7- 41�__ 4-(0 Check No.: 125-3 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaran fund Sigma nature of Agent/Owner .Signature of contractor Location ! ' 544e� No. Date iV f o - TOW_N OF NORTH ANDOVERA_, o � Certificate of Occupancy $ a Y Building/Frame Permit Fee $ r. 0 Foundation Permit Fee $ a Other Permit Fee $ w ' TOTAL $ j7r Check# 28109 Building Inspector ■ i Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE'OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swinuning Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ permanent Dumpster on Site ❑ I THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature— COMMENTS i nature 9 _ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Si nature COMMENTS e Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/signature& Date Driveway Permit _ y DPW Town Engineer: Signature: ffi _ -g FIRE DEPARTMENT - Tem Dum sten on site Located 384 Osgood street p p yes no - Located at 124'Main,8treet - Fire Department signature/d'ate COMMENT'S,._ ■ Dimension Number of Stories: Total square feet of floor area, based on'Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) Ih ❑ Notified for pickup Call Email i Date Time Contact Name Doc.Building Permit Revised 2014 Dimension Number of Stories: Total square feet of floor area, based on.Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application o Workers Comp Affidavit o Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 �1 _� w-�' y 4 � n"tti�r TMC"f A� lX' "ixk+3':- "..�.`v "."'.''•a`'k.:Tr F✓my`...s: ...... �. { F. ,�. ..'.�. . (;' .,.�+''�'�k<�.;... ":,c.> •� ....,ai k:+-........ '�ti'.` n:ii'Ys X ^Y;;:-/4 NORTH Town of t E : ., Andover O - N.I . 90 Nikow 6 _'m7 h 0;;N.A--. h ver, Mass, COC NIC MI WICK 1• 7,4 A°RAreo S U BOARD OF HEALTH Food/Kitchen -PER IT LD Septic System THIS CERTIFIES THAT .......... ...... ........................................... .. ................ ............... BUILDING INSPECTOR . .................. it. S .... Foundation has permission to erect .......................... buildings on ...... ..... �� ... .. .. Rough to be occupied as .........W.N..V) ....1. .... . . ......... ............. Chimney ..... . provided that the person accepting this permit shall in every respect conform to the terms o the application Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alte tion and Construction of Buildings in the Town of North Andover. fto PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough �J Service ........ .... . /....5.: -: .................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildinz 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. E k i 0 ��re •a�vgs MA tvjU Tim I � I-Y L- 59 F ` � 4-01=- CL O go AL Fame hommor- 3.D Iaabooevwowe�d�q�aS. ��'��' ILEF - ho tma Law►4aw W;d6w ' l�i°l Fi &can=d.� a ofap��a�►r��iBoi�Bb�e�editsagiy �,s� odm � a!l�ie�7lillirms�+ - . z�sdamae�+siaa�'i�dv,�Biis ��+� ��•�s4q�ilp�lsBoe�rar,�y� d',�a�4t�toirat - &oma Client#: 58837 BUILDI DATE(MMIDDIYYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 05/12/2014 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). C N A PRODUCER NAME: Davis&Towle Group PHONE 603 428.3238 _ Arc NII: 603 428-3992 AIC No. E�: E-MAIL Proctor Square ADDRESS___ P.O.Box 2.300 INSURERS AFFORDING COVERAGE NAIC fl Henniker,NH 03242 INSURER A:Acadia Insurance Co. INSURED INSURER S: Building Efficiencies LLC INSURER C: 18 Tanguay Avenue INSURER D: Nashua,NH 03063 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 CONTRACTOR 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 ADDL SUBRI POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NUMBER MMIDD MM/DDIYYYY A CENERAL LIABILITY CPA504862912 05/12/2014105/12/2015 EEAAqCH or-CCURRENCE $1 000 000__ { PREMISES E.occcurrrence 5250000 X COMMERCIAL GENERAL L;IABILITY CLAIMS-MADE I ^'OCCUR MED EXP(An one arson) $5,000 PERSONAL&ADV INJURY $1,000,000 ! j GENERAL AGGREGATE s2,000,000 PRODUCTS-COMP/OP AGG $21000,000 GEN'L AGGREGATE LIMIT APPLIES PER:ri $ POLICY X PFRCT LOCCOMBINED SINGLE LIMIT $1,000,000 A AUTOMOBILE LIABILITY C�AA507617812 5/12/2014 05/12/20'1 acaden BODILY INJURY(Per person) $ X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE S NON-OWNED Per accident — X HIRED AUTOS X AUTOS ; $ A X UMBRELLA UAB X OCCUR CUA508185912 5/12/2014 05112/2015 EACH OCCURRENCE $5,000,000 _ EXCESS LIAR I CLAIMS MADE AGGREGATE s5,000,000 $ DED X RETENTION () IWC STATU- DTH- . WORKERS COMPENSATION WCAS04863412 5/12/2014 05112/2015 T.RY L AND EMPLOYERS'LIABILITY Y/Ni E.L.EACH ACCIDENT $500,000 ANY PROPRIETORIPARTNER/EXECUTIVE IN/Al OFFICER(MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500000 (Mandatory In NH) If yes,deealbe under E.L.DISEASE-POLICY LIMIT $500 OOO DESCRIPTION OF OPERATIONS below , } DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) *"Workers Comp Information** Proprietors/Partners/Executive Officers/Members Excluded:Jonathan Included states—NH&MA CSG,National Grid,and NSTAR and named as additional insured as it pertains to the work being done during the policy period. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Conservations Services Group THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 50 Washington Street ACCORDANCE WITH THE POLICY PROVISIONS. Westborough,MA 01581 AUTHORIZED REPRESENTATIVE C 1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD ELS #S160252/M160249 i Board of Building Regulations.and S%wctdrnS ucense CS-104159 ANTHONY J GRWO 42 WMTTIER S I 1 HAVERHILL MSF 018 02/25/2016 I Office of Consumer Affa'rs d Business Regulatton 10 park plaza- Suite 5170 I Boston, Massachusetts 02116 I Home Improvement.Contractor Registration Regijovbon- 167942 Type: Supplement Card Expiration: 11/1714014 BUILDING EFFICIENCIES, LLC .- ANTHONY GRIECO _ - - 4 JOHN TYLER DRIVE, SUITE E MERRIMACK, NH 03054 Update Address ad WOW C] card.Marti reason for cbsuge. [] Addrew ❑ Reoearal [ zusployawt ❑ Lost Card sca i 0 20easn r umm I �J/te ones�+onu�eal//�i o�t rs�an6 or rqfttntba valid for in wMal we only of Coasmw Affairs A Betlness awlafto befa,e Ne e=pkrataa date, if found retara U: 1 ME 11111pROY MENT CONTRACTOR pWIN of Coasuaer Alhirs sod Baines Regukd" I . 161w Typo. 10 Park pbu-Suite 5170 EVkathm 11117111f14 Suppion et Card Boswu.MA 10116 BUILDING EFFr—Emc1%-We AND40W OWco 4 J0t91 MER ORNE.SUM E _ Net sew �ROACK,*4 03054 Uedersetrseay t CONTRACT FOR Conner anion PRODUCTS � .SERVICE WORK Services Group This service is brought to you through support from your local utility This Agreement is made by and among and Maureen Iteinze Conservation Services Group(CSG) I1 Appleton St Attn:RCS North Andover MA 01845-3119 60 Washington Street,Suite 3000 Westborough,MA 01581 Site ID:S00002161583 Westborough, No. 173484 Project'1D:P00000166307 Federal ID No.222457170 Customer ID:0000001.71633 Contract ID:20/31017 WORK (Mail completed contract to address above) 1. DESCRIPTION OF WORK TO BE PERFORMED Contactor will perform or cause to be peiformed the following work on these"Ptendses"in a professional m:uuier mid in accordance with the terms of i Ilris(cxr4acl,mdudltg Ute attacirerl rvcommendatlons/worlc order describing the work in detail(the"Work")which are hicorporated herein by reference: i r s Description Quantity Location M1L FFloor Offen Blaw Cellulose 6"_ _ 731 Hatch:Thermal Barrier Polylso 2 inchjAttio�� _.. 1 living Space^ — $41.71 i Dammlr►�_�_._�.__. .�___�____� ______ __58 4TN%A _N . �__.�,_.�_.__ ._.._.$127.02 Hatch:Thermal Barrier_P_otylso 2 Inch(Attic) _ 1 _ L1vin 55 eco $41.71 lnatrlate vin Sided Wall With 3"Dense Pack Cellulose 1,150 -__Living Space _ __ $3cCg.00_ Blower h wer Door Test On D rwstic Testin Pad.,_. 1 N/A $65.70 Sub Total: $4.374,71 i Utility Incentive Share $2,000.00 Customer Contribution $2,374.71 ! i i i a •a For office use only Printed:7123/2014 Pape 2 of 2 . i PAYMENT C Customer agrees to pay Contractor for the Work,the(`,ttstonrer Share of the Contract Price as.follows:Privrnerit til:$ ma Depgxit payable to CBG upon signing the Contract(not to ere 11 o.th;.txrtarliviall costs).Matt check Rc contract to CSG,Atter:RCS,60 Washington St.,Ste. 3000,Westborough,MA 01881.Flnal Payment:S as(lie final payment for Uie Work shall be payable to the Independent IneWlatlon Contractor("UC")upon satisfac ory completion of the Work Customer widettstands that hefshe will out.be required to pay the fla ty Incentive.Share of the Contract price in the amount of s 7-= Changes to Individual line items and/or previous Incentives may increase or decrease the size or the Utility lneenave Share. Ili.DISPUTE RESOLUTION The nC and Crestumer m ui advance that in the event:that the tIC has ac hereby trWal�epee fispute coticentirtg Oils(:untraet,Uie ifC nu>:v sulrndtavrh dispute to a private arhitratirui service whk3n has been approved by the Mee of Cnnsurner A8'.ta;s and Rrrdness Reptlation and Customer shall be rc(iulm i to submit to Latch ambIbrition as pmvided in M.G.I.r 142A. I You may cancel this agreement if it has been signed by a party at a place other than an address of the seller, provided you notify the seller in writing by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third bust ss day following the signing of this agreement. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Gtrstom t ignat _ Dante 23 t ludic- ynur si•lected IIC bete,if applicable t01) Initial here i you want. 1 G the Program to assig n a a Date Name of CSG Repines vt,(Printed) Participating Contractor TEIMIS AND CONDMONS APPEAR ON THE REVERSE. 3/ld F J ^C CONTRACT CT F®R t Conner ation PRODUCTS ,S'E'RVICE WORK Services Group This service is brought to you through support from your local utility This Agreement is made by and among r mut Conservation Services Group(CSG) j It:'Ialireen Heinze Aur:RCS 1I Appleton St 50 Washington Street,Suite 3000 i Not'tti Andov&,MA 01845-3119 Site ID:$00002161583 Westborough,MA 01581 Reg. No. 173484 Pto'etfID:p00'000]66307 Federal 1D No.222457170 Customer ID:C00000171633 (Mail completed contract to address above) Contract ID:201310I7 ASEAL 1. DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed die following work on these"Premises"in a professional manner and in accordance with the terms of this Conor=,including the attached recommendalionsrwork order describing the work in detail(the'Work)which are incorporated herein by reference. Description Quantity Location Perto MAir Sealing at Estimated 62.5 CFM50 Per Hour _�6 .__LI lug Space ------5505.92 Door Sweep _ _ _ -- _ 1 _ N!A _ _ _ $23.18_ Exterior Door Weather SLdpp^94.� $27.59 Sub Total: $558.69 r Utility incentive Share $556.69 Customer Contribution $0.00 II • I Ciel Fpr oifics use only Printed:7123/2014 Page 1 of 2 II. PAYMENT customer agrees to pay Contractor for the Work,the C ustomer a of the Contract Price as follows:Pavmc nt 61:S tis a Drposit 1 payable to CSG upon signing the Contract(not to exocod f the total retail costs).Mail check&contract to CSG,At CS,50 Washington ft,Ste. 3000,Westborough,MA 01581.Fund Payment:$ a5 the final payment for Um Work shnl I he paystilh to the Independent installation ; Contractor("i1C")upon eatists o n' letion of.the rk.Ci sionter understands that he/she will not be requimd in pay the Utility lnceutive$1we of the coat-ad price in the amount of s .Changes to ifidhidual line items and/or previous incentives may increase or decr&tisc doe size oT the.Utility Incentive Share. Ill.DISPUTE RESOLUTION 7be QC and Oust riser hweby matwAY agree in advance that in the event that.the BC las a dispels concrnintg flus C<tnllru t,rix pC any skibmit such disprda ru a pdvak'arwaatkn 1 seivkx wNchltasboM apptovedtry the Office orCwtsumer Affairs and Business Reguladun and Ckwtrntter shall in:requirvd ro suhniii io arch adlnsuioni as pnrvirled in 1i,r;.l.c 1112A You may cancel this agreement if it has been signed by a party at a place other than an address of the seller, provided I you notify the seller in writing by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. DO NOT SIGN THIS CONTRACT OF THERE ARE ANY BLANK SPACES. (OR) I Cu nut I)at0 Indicate nut Q.lecIVI IIC hart•.if alrplicable Initial heir,if you wtuil, i j the Program In assign a i CsG Datc Name of ISG Repress 've(Printed) ParUcipadtig Cotitt-acurr TERMS AND CONDITIONS A"EAR ON THE REWRSE. 3114 J