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HomeMy WebLinkAboutBuilding Permit #848-2016 - 125 PHILLIPS COMMON 2/1/2016 f ND oTh q BUILDING PERMIT 3���::,. `•6�°� TOWN OF NORTH ANDOVER - o a APPLICATION FOR PLAN EXAMINATION - Permit NO: Date Received °4 . / 40, ^TED P� Date Issued: / 9SSACHUSE� IMPORTANT: Applicant must complete all items on this page L AT r _ r WY "l ' OMI+ . - €'•. F?�AI�I� 414- � iso ` tict s T TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ane family ❑Addition ❑Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other o ` s - f ,$� � � S L-1A., ck6 O- Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: 1 2 L t S D S NIr h "MIN &; w. f i v �pyy n y� r 6 Wi Lit T 7F7 r " �a #- Joe F , 3 14 , s u x ARCHITECT/ENGINEER (U I Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ay- FEE: $ "36- Check 36•Check No.: t? Receipt No.: Zq 97/ NOTE: Persons contracting with unregistered contractors do not have access to the uaranty,fund eT i� u�`ef rt#r.�—tlml i n Aj//oLocat o ! No... �d✓� Date 2 /1 • - TOWN OF NORTH ANDOVER ` Certificate of Occupancy $ Building/Frame Permit Fee $ � Foundation Permit Fee $ '' Other Permit Fee $ TOTAL Check#31B 2 9 9 Building Inspector s NORTH own o ndover Z oh ver, Mass, COCHICM[WIC" �qs RATES ►.P�,�'�y . fJ BOARD OF HEALTH I Food/Kitchen 'PE�R IT T LD Septic System I - THIS CERTIFIES THAT ....... �.. .. .... ... BUILDING INSPECTOR .... .............. ......... ................................ ... ..0. ....0.L...-....x1__WI \ Foundation has permission to erect ................b ildings on ........ �!............ ........... - Rough � to be occupied as ........ 1�.. �.�. ..... .... .....1.1� U .............................................. Chimney provided that the person accepting this permi3all in every respect conform 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 Rough VIOLATIONof the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU TION TARTS Rough Service ..... .. ..... .... ......................................................... BUILDING INSPECTOR Final GAS INSPECTOR Occupancy Permit Required to 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. CO-OP POWER ilV`GNW.CCCPPCWER.COUP building community-owned sustainable energy 10, January 26,2016 To Whom It May Concern: Enclosed is an application for a permit for insulation works at 125 Phillips Commons, North Andover, MA 01845 and 328 Summer St, North Andover, MA 01845. We are authorized by the homeowners to obtain this permit — a note of authorization is included. I believe I've included all the necessary paperwork to have these processed, but if there's anything missing, please feel free to call me at the number listed below or send an email. Please send permit in the enclosed stamped addressed envelope or let us know when the permit is ready at 617-272-3340. Thanks you very much! Best Regards, i 0 lue'Knight Office Manager Co-op Power 1476 River St, Hyde Park MA 02136 (617) 272-3340 olive@cooppower.coop Co-op Power is a consumer-owned energy cooperative bringing you quality affordable energy efficiency and renewable energy. Co-op Power 15A West Street,West Hatfield,MA 01088 Boston Office: 1476 River Street,Hyde Parr,MA 02136 phone:413.772.8898 or 877.266.7543.Hyde Park:617-272-3340 fax:413.517.0300 Email:info@cooppower.coop Website:www.cooppower.coop 4 i . M1 sg Shawmut Roan Unk2l CartonMA, 020211339-,42-6335 RISE ENGINEERING wanOUSEengineering.com Emden Cy Energized. OWNER AUTHORIZATION FORM (Jj (Owner's Name) owner of the property located at: 1 - Co/11 YPvo S� (Property Address) ' (Property Address) hereby authorize °�— �% 19 Lj.9.J?.r (Subcontractor) K an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform worts on my property.This farm is only valid with a signed contract. Owne! Signature Date t Pedersi iD 9t}S4405628 5 RISE E'ngille'.e1-ng R!Con dor Regialrahon Mo 0186 ISE MA Contractor Registration too 120979 `« A division ofThietsch Engineering Ni INEERING` 60 Shawtnut Unit#2,Canton,MA 0=1 334+502.(x33$ FAX 339-5025 CONTRACT - Page 1 PROGRAM Ytascx»rrnnct4arrrrusrciat rrx CMA-HES Man>�&cusrbraQar�r utas n�s�a�o v p"M .�..�_ pati amWa .�voreM pavid Garcia (503)313.3260 42/271/2015 422895 00002 euae; r en�xm srrr - 125-P*llips Commons. I25,Thillips Commons North Andover::MA 01845_ North Andover,MA 01845- j . DEC01 109'DESCIUPTION 14i0.7.'A 13A"itltti R:We F v4 idlntiili�d'that ih ze-are recessed'ilghts pr tt M°your,home,unless the recessed lights arc certified fG-r l{fn ttli n C+»tiact Rat+ "roc t 71 fc n 3"a lesran space %t4 ifhe fixture by using Blass bfinket insulation as a tlmt ming materiul�ria ins ittatW will b6tistillicil actoss the top-and,614sed cavities which contain rmftcd lights will not be insulated. Sfl:00 AiR SEAUNG:l ldc'lalto,md matexials to seal arra of your horac a�wasteful,exom air leak ."Thus work will be perfarrtt in concxat with the use aT9pecal tools and diagnostic tests to assruc that your home wil l be Ieft with tt healthfuh level of 'ta°ractttarigc acrd iridorxr air.qualiiy.Mauls to be used to seal your home enclude caall;s,foams and other,produets. Primary 'alieas'fgr�alttig•'riuotnde air"Ilrrtge to atiics,basements;attached a �oral othrx unheated arms(windows are not generally addicsta This will require{>}worlwiag;hours.f redurairin in eubic feet minute(cfm}ofnrir infiltration will cur,but the notual purtNbcr-of cim•is mil gunteeel� i At the completion ofthe weatherization work acid at no additional cost to the homeowner,a final blower door andror combustion *una 6 will lie eohducted by.the sub-to+iractor to ensure the 9af ety of the indoor,lir quality. $680.00: DAMMING Pravfde1abot and mauls to ittszall a l2"layer afR 3s,unfaicdAberglass'ham to(68)square fed tordemming purposes. $139,40 71 i'flir:h?l A f:Pitrir de.latior and materials to install a 4*"layer:of 44 Clad1 C I'Mato added to(940)square fed ofopen attic r 9plicc. $1,062:24; KNEEWALI.FLQOR Provide labor and materials to in",,4"la)W-drt-4,Clr "I Cellulose added to$0)square feat ofopen ...dOTRuoafooVtYTGITSPACENAGfORDiSCt fibhil6ki RECOMMENDINGDESIGNATED K.WAII SEG lTOM $44.40 A't`'f't ,A SS,Provide It 'tokimaterialstp n5utaic the back of(i)stttc'bo6h with 2"rigid The»nax Board,Wratherstriit the pedracter, SW C{7h lYM WAt:LS:'Ptrraidc abar l'rrtatarial 46 install 2"FSK'far at sem%iig d'filrerglsrs§Board insulation to(108)sgtrare feet'of cottrm I iM oleo S379M ltl lB h rteermg will apply.al!applir-A iligable'inrx tivcs to this ct4ntract. You Will only be billed Halder amount. curre"lly, for o win""' incentive,nat to eeQ'S il0 per'�endar ,}ler,and It incentive of l MI/ for the ' ixrsures,Columbia Gag olTer"s 75'x, Air Suing mgr s up to tWtiist 684and t addititatal 5340 ifsav ng=arejustified by the auditor; For the celery and;bealth ofyrt ur home's indoor air quality,we will be condueling'a blower door diagnostic of the available air flow in your Wrn'botb,befare the wort.is dun,and after the weatherixateon work it complete: /owill also cxmduct a richt assessment of Me eotrt6ustion safrtyofyot►rItnbun 'systeiit and water healer,`fit a Wile'al'M and i9 at no eirst to you. Total allowable uxathe la tion incetiti3e is-j;ii0 "A00 1 I I t Federal ID#03.0005029 MISE Engineering RI Conhador Regittration No 8186 ILJNA Contmdor Rulon No 120979 A division offbicisch Eoginccring ENGINIEtOING 60 Shawrout Vait a Canton,MA 02021 339.502-035 FXX 33942 3433 ON i RAC E Page 2 PROGRAM rim coti73RRCS:IB wtmw 1NT0l3!?Ywwl Pin CMA.-HES HtN,it3FEtCNi: tCNEif5YO1�P.R iRY70RK AS .�..,_,mss a ott PHari David Ciaccia (503)313-33260 12/21.12015 422895 00002 Sam"SWW" SUM WNMT 135 Philiip3 Common_s 125 Phillips Conimons SOME ON.STATf,VP.�.. �MY,OTAMz9N__n_ w...,. ...�..,.._..,.,.„..,�. .w.,....._.......� E North Andover;MA.0184.5- North Andover,MA 01945- JOB DESCRIPTION f 1 Total: $2,454.00 Program Incentive: $1,943.00 Customer Total: $511.06 WE At9REE WMW TO FMRNISH SERVICES-tXIt MIM IN AGGORDUCE WrM ABOVE SPt'R"MATi NS.roR THE Sill 01: i 'Five Hundred Eleven&001100 Dollars $511.00 ttP$HI .lAI.3H8PrC11GE.9HQAhPR0YA1.@11� €di6itTEfiRiItD.CU-3Tt SFStA#SR&ESTCfI'idlri+NfOUNTnUEItaCt�G[»ft#i'EREBrOFi Y l :i S'tDEDl2Q1 NL.yONANY rtraoa�wr:c,�A ,�nAvs. rmosrArrr Trow+a���.mcwrsorrsmrs,�s�sFauu�c.arsocnr�rnaeroariEcrsxxair 00 NOT SIGN THIS CONYRACT IF THM ARE ANY BLANK SPAM slau�+Rxe- tCE. tHtiTEtTHr.4C0tdt'�ACTMAYO�EVtIYHDAAY1tsEYi i!'t3QTE%ECUTEA7NSYiYa bAM0FAtCWTAGCE .....:......v.,..........>..,......_._..,_»....._-_..,...���,�. „-M AtX.EPTE tiF CO?7tttACt,YFiE 48ovE putt .., MIS AND COW"ONS ARE . 30 DAYM siAMFIZ0470 US WD AMHIMMY ACCEMED.VOUME AUTk0=0 T0100 � WORK �. - AS SPECUr-M PAYlrEt VML BE MADE AS OU1UMM A40W . i f I I (I 6 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Co-op Power Address: 15A West Street City/State/Zip: West Hatfield, MA 01088 Phone#: (413)772-8898 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 20 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs / insurance required.] t employees. [No workers' 13.2 Other I r')S tl,lfC. 0 ✓\ comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. j t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: HDI Gerling America Insurance Company Policy#or Self-ins.Lic.#: EEWGCC000187715 Expiration Date: 11/08/2016 Job Site Address: j _ I jl `tt PS am M OA-S City/State/Zip: ,1�'f141-o1 A 0 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine ' of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cern er--the pains and penaltie �eer that the information provided above is true and correct. Si natur - Date: l P one L 3 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ` DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE i.►�'f 11/12/2015 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 Co 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 CONTACT NAME: Debbie MacNeal James J. Dowd & Sons Ins PHONE FAX 14 Bobala Road AIC No Ext:4 13-538-7A/C No: Holyoke MA 01040 ADDRESS: dmacneal@dowd.com PRODUCER CUSTOMER ID#:COOP INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:HDI—Gerling America Insurance Compa Co-op Power, Inc. INSURERB:TOrus National Insurance Company 25496 15A West Street West Hatfield MA 01088 INSURER C: INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:1503274623 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 DL SUBR POLICY EFF POLICY EXP - INSR D POLICY NUMBER MM/DD/YYYY) IMMIDDIYYYYI LIMITS A GENERAL LIABILITY EGGCC000187715 11/8/2015 11/8/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE (RENTED PREMISESS Ea occurrence) $100,000 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 X POLICY PRO-JECT LOC $ A AUTOMOBILE LIABILITY EAGCC000187715 11/8/2015 11/8/2016 COMBINED SINGLE LIMIT $1,000,000 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY(Per person) $ X SCHEDULED AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $ Comprehensiv $ B X UMBRELLA LIAB OCCUR 70354QI50ALI 11/8/2015 11/8/2016 EACH OCCURRENCE $1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $1,000,000 DEDUCTIBLE $ X RETENTION $10,000 $ A WORKERS COMPENSATION EWGCC000187715 11/8/2015 11/8/2016H- AND EMPLOYERS'LIABILITY Y/N T RY L T R ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory 4n NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS OC IONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if mores ace is required) ) Certificate Holder is named as Additional Insured per written contract in regard to general liability only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Thielsch Engineering, Inc. 195 Frances Ave. Cranston RI 02910 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD �' ? y/° )�/ {dTIte - f •[sl/2.Lll..•" {�`GG =moi/'• Office of Consumer Affairs anal Business Regulation. 10 Park ,Plaza - Suite 5170 Boston. Massachusetts 02116 Home lmprovern.�nt' ontractor Registration Registration: 165217 r (JJ Type: Supplement Card w -� Expiration: 1/21/2018 CO-OP POWER, INC. LEAH DANIELS 15A WEST ST WEST HATFIELD, MA 0108$ Update Address and return card.Mark reason for change. seA1 t': 2OM-n11 Address U, Renewal � Employment i...� Lost Card �, �n;..\ ,( ffic.e..of C ousunter:'Affairs tit KuSitiess Regulation License or registration valid for individ l use Ok�IY before the expiration date. If found return to: r ME IMPROVEMENT CONTRACTOR P Office of Consumer Affairs and Business Regulation Registration: 165217.'." Type: 14 Park!'laza-Suite 51.74 Expiration: 11242018 Supplement Gard Boston,MA 021.16 CO-OP POWER,INC. ` LEAH DANIELS 15A WEST ST WEST HATFIELD,MA 01088 Undersecretary Not valid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-097409 f Construction Supervisor ' LEAH M DANIELS 12 MARCELLA ST -� ROXBtIf2Y MA 02119 : ,. I Expiration: commissioner 05118/2017