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Home My WebLink AboutBuilding Permit #1339-2016 - 300 PLEASANT STREET 6/27/2016 nA �� O� NORTH9I'j IVJI� BUILDING PERMIT t�tLE° ;6,do TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION �o Date Received Permit No#: 4q � C Hus�� Date Issued: + IMPORTANT: Applicant must complete all items on this page LOCATION aac) Print PROPERTY OWNER EMI) Print 100 Year Structure yesCno MAP �PARCEL:6b�ZONING DISTRICT: Historic District yes Machine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family [I Addition T�Zwo or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other ElSeptic p Well ElFloodplain [IWetlands El -Watershed,District ❑Water/Sewer DESCRIPTION OF WO K TOB PERFORMED: J� Identification- Pleas Type or Print Clearly t�, OWNER: Name: 11 Phone: �� — D 7— Address: Contractor Name: ( .LL14mn Phone: 14— 1-11 Email: rcL Address: l Supervisor's Construction License: �iqExp. Date: Home Improvement License: ( Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ ��` �. "z; l FEE: $ � Check No.: la� Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guarantVfund r Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL ' Pubi newer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dwnpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments v Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIREtE-M RaT�MENiT .md� a _z LocatedLaf 1�24tMvamtStr^eet� - - Fi:`re Departrientsignature/date _ `�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) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Pennit Revised 2014 - -- r 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 Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4, Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses :aE 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 OTE: 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 2012 IECC Energy code 4, Engineering Affidavits for Engineered products OTE: 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 down of North Andover payment Date Monday,June 27,2016 )eposit Number 1606271 )perator Counter pc 1 ACR(BUILDING INSPECTION) $43.00 G dotal Paid $43.00 :ash $43.00 :hangs $0.00 ieceipt Number gov00004808 1/2712016 2:05:26 PM :ashier Id. treascoll-17 Location No. f �/ J� �'��,. Date� 17, y+ . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ _ Check# ' t�` } E Building Inspector � NORT1� Town Of ndover 0 : :.No. I t C% h , ver, Masollikoe.,0 LAKE al l COCMIC"Imcx 1' RAreo APA`,��(5 , U BOARD OF HEALTH PER Food/Kitchen IT T D Septic System THIS CERTIFIES THAT .........:�-- ,, O & ....... BUILDING INSPECTOR ..... ........ ..... ........................................... Foundation has permission to erect .......................... buildings on .%.6 .. ... A�. Rough to be occupied as .......... �e-4 Chimney provided that the person accepting this permit shall in every respect conform to the terms of the app ication Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Ins ection,Alteration and Construction of Buildings in the Town of North Andover. l PLUMBING INSPECTOR eei 1 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MON T S ELECTRICAL INSPECTOR UNLESS CONSTR A Rough Service ... ...... ....... .. ........ . ....... Final l BUILDIN PEC R 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. ti Federal ID 0 05-0405629 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120978 A division of Thhelsch Engineering CT Contractor Registration No 820120 60 Shmvmut.Canton.NIA 02021 339-502-5197 FAX 339-rr -045 C®NTMMCT Page 1 PRWRAM TM C*Ut*AWMenM WOWn►VM a6E CMA-HES a amANOMMMCusmreawns ewauc AW-cusicka- PHM DME o[MMY 0 Leslie Thyne (617)966-4514 12/14:2015 427357 00002 MUCIMMM 11"M MUM 300 Pleasant St 2 300 Pleasant St 2 North Andover,MA 01845 North Andover.MA 01945 JOB DESCRIPTION AiR SEALING:Provide labor and materials to beat areas of your home agaima wasteful.excess air lockage. This work will be pLrformed in concent with the use or special tools and diagnostic tests to assure that your horn:will hu:left vith a hoahhrtd Ieu'el of air exchange and indoor air quality.Materials to be used to seal your home can include caulks.foams and other products. Primary arra%fur scaling include air Irikage to attics.bnxcments.attached garages and tether uniteaicd areas(windows aro not generally addressed.I This will require 17)working hours. A reduction in cubic feet per minute lefml of air infiltration will occur,but the actual number of cfm is not guaranteed. At the completion of the%veatherimtion work,and at no additional cost to the homeowner.a final Mower diur andor combustion safety onal)sis will be conducted by the sub•contraeor to ensure the safoty of the indoor air quality. S595.00 nAMMING:Provide Intuit and materials to install a 12"layer orit-is unfaccd fihLniass butts io(121 square feel for damming purposes. 534.60 ATTIC FLAT:Provide labor and materials to install a 12"layer of R42 Class I Cellulose added to 184Ui square feet of open attic apace. ATTIC ACCESS:Provide labor and materials to install 1 I i easily moved.insulating cover Car the attic access fielding stair. The cover has intog-rat iveather-stripping to restrict air leakage. S-N10.00 VENTILATION:Provide labor and materials to install(I i insulated exhaust hose with roof mounted flapper vent to exhaust existing bathroom raw). $11 X.73 VENTILATION:Provide labor and materials to install ventilation chutes in(43)rafter bays to maintain air now. 590.00 GA RAGE CEILING:Provide labor and materials to install 10"R-33 densely packed Class 1 Cellulibc in<ulation to 528 square feel of garage ceiling located below a heated floor arca,by drilling holes in the ceiling from below. I totes drilled will be pluggcd. Plugs will be spackted and left in a relatively smooth condition.Finish sanding and touch-up priming!painting will he the customers respoust'hilky. St.IP12.96 RiSE.Engineering still apply all applicable,eligible incentives to this contract. You will only hoc billed the Net amount. Currently.for eligible nwawres.Columbia Ga.,often 73%n><-entive.not to exceed 52.000 per calendar year.and an inecntivc of too*."for the Air Scaling rtumsurc+ up to the first 5680 and an additional S340 if savings are justified by the auditor. For the snkty:rod health of your humc's indoor air quality.we will be conducting u blower dor diagnostic ot'tlte available air flow in your home both before the work is begun.and after the wcathcrizatiem work is complete.WVc will also conduct a full axa-ssmcnt orthe L-aunlrustion safety of your ligating system and water heater.This has a value of 591i and is at no Lost to you. Total allowable weatherirationt incLmtive is S.i.l 10. SIVA) RISE Engineering Federal ID 4 OS-04OSS29 Rl Contractor Registration No 11196 A dicisinn of 7biclscb Engineering MA Contractor Registration No 120979 R 0 CT Contractor Registration No 620120 60 ShDaTnut.Cancun-NI A 02021 CONTRACT®®pp/+ 339-502-5197 FAX 339-502-6345 CONTRACiT Page 2 PRO(i1t11\i THIS CONTRACT IS ENTERED INTO BETWEEN RISE CNIA-HES OESC ID`oBMECUSTONEDFORWORNAS 0 i.cslic Thync (617)966-4544 12114 3015 427357 00002 300 Pleasant St 2 300 Pleasant tit 2 North Andover.MA 01845 North Andover.MA 01X45 JOB DESCRIPTION Total: $3,555.31 Program Incentive: $2,685.00 Customer Total: 5870.31 WE AGREE HEREBY TO FURNISH SERVICES.COMPLETE DY ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF 'Eight Hundred Seventy SI 311100 Dollars $870.31 UPON F UNPAID AACFTN)NANO APPROVAL BY RISE ENOMEERMIX CUSTOMER AGREES TO REMM IT AMOUNT DDE FULL INTEREST OF/y WU BE CHARGED MONTHLY ON ANY TER 30 DAYS.SEE REVERSE FOR IMPORTANT DIFoeRATION ON GUARANTEES.RIGHTS OF RECISION,SCHEDULING.AND CONTRACTOR REGISTRATION. OT SIGN THIS CONTRACT IF THERE PACES NOTE,THIS CONTRACT MAY BE VdTHDRAWN By US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE ACCEPTANCE OF CONTRACT-THE Ae E PWCES.SPECIFICATIONS AND CONDITIONS ARE 30 DAYS. AS SPPEC, PP fyAI B E AUTHORIZED TO 00 THE WOAK i .�, E RISE60 Shawmut Road,Unit 2 1 Canton,MA 02021 (339-502-6335 ENGINEERING www.RISEengineering.com Efsjtien,-_neri izee. OWNER AUTHORIZATION FORM I Frank Fodera (Owner's Name) owner of the property located at: 300 Pleasant Street, North Andover, MA (Property Address) (Property Address) hereby authorize Lv a , (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. ees nature I al 1 Date The Commonwealth of Massachusetts rrm�read Department of Industrial Accidents d+ t Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leyibly Name (Business/Organization/Indivi dual): Builders Services Group d/b/a Quality Insulation Address: 110 Perimeter Rd City/State/Zip: Nashua NH 03063 Phone #:603-324-1974 Are you an employer? Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 100 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have g. ❑ Demolition employees and have workers' working for me in any capacity. 9. E] Building addition [No workers' comp. insurance comp. insurance.* 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised their 11.[] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[:] Roof repairs insurance required.]t c. 152, §1(4), and we have no Weatherization q ] employees. [No workers' 13.2 Other comp. insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: ACE American Insurance Company Policy#or Self-ins. Lic. #:WLRC 48151553 Expiration Date:6/30/2016 Job Site Address: �� 71�12 S" 4— S d City/State/Zip: ✓� !`7 U � S 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 certifv under the pains and penalties of er'ury that the in ormation provided ab ve is true and correct. i L0 7 Si ature: Date Phone#.603-324-1974 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#• CERTIFICATE OF LIABILITY INSURANCE DATE(MI�.DD YYl') / E 06124/2015 NCEt I^ - THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFlC:.TE 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 BEMIEEN 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 CONTACT a' MARI' a AOn RTSk SE:rV lceS Central, Inc. PHONE FA): Southfield MI Office (A/C.No.EXIT (6b6) 28 -%!" AC N. (f 003 363-010; 3000 Town Center E-MAIL Suite 3000 ADDRESS: O Southfield MI 48D75 USA INSURER(S)AFF ORDING COVERAGE NAIL INSURED INSURER A Old Republic Insurance Company TODBUi Id COFD_ INSURER e ACE American insurance Company ?266; aytona Bec Ch1 FL 32114 USA INSURER ACE Fire underwriters ]nsurence Co. 2070.' INSURER D IIUSURFR E INSURER F: COVERAGES CERTIFICATE NUMBER.: 570055348382 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 HEREIw IS SUBJECT TO ALL THE TERnrS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOVVN MAY HAVE BEEN REDUCED 5'Y PAID CLAUJIS Limits shown are as requested S' TYPE OF INSURANCE S R POLICY NUF.IBER OL CY c O CT Y. U1.91Ts _TP. INSD wvD (POLI MM/DDIYYI'YI I(rdnODD.rYY1Y1 A GON.MERCIAL GENERAL LWEILITY f-0l:r?Y 30;834 UDS 1U/_' 1J Ubj•JU%:Ulb EACH OCCURRENCE 1_,000,000 CLAIMS-MADEX❑OCCUR. UAMAG O n'TED 52000,000 PREMISES(Ea--e—) MEDEXP(Any ane person) 325,000 PERSONAL&ADV INJURY S2,000,0D0 o GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 54,000,OLIO m X POLICY PRC' JECT E]LOC PRODUCT-COMP/OPAGG S4,000,000 m u OTHER v 0 AUTOMOBILE LIABILITY Ni:T6 304.835 06/30/201 SJ0&/3D/?016J COMBINED SINGLE LIMIT 55,OOD,000 � (Ea...id=ol) ANY AUTO BODILY INJURY(?er person) O AUTOS AUTOS ALL UTOVJN'FD Z SCHEDULED 'ODRY INJURY(Per...dM) m X HIRED AUTOS X NON-OWNED PP.OFE P.TY DAf.Ar.GE U AUTOSId Per.ccidenlj U3EBFE LLA LIAB OCCUR. EACH OCCURRENCE CJ E:CESS LIAR CLAIMS-MADE AGGP-c GATE DED RETENTION WORI<RS COMPENSAilO N AND WLRC48151553 061130,111015106,130/20](11 PER OTH- EMPLOYEP.S LIABILITY �` STATUTE ER ANY PP.OPRiETC•F./PART NF P.I EXEC OTIVc ��Y/N All Other states OFFICER/MEM.B[R EX.CLUD-0' N N/A SCFC481519D 06i 30!7015 06;'30:016 cl EACPACCIDENT 11,000,0010 (Mandatory In Ni-O ��1111 wi On 1 y E l DISEASE-EA EMPLOYEE S1,000,000 it ye F ticsenbe under DESCRIPTION OF OPERAT IONS be I.- E L DISEASE-POI.ICY LIMIT 51.000,000— I I I I RIPTION OF OPE RATIONS/LOCATIONS/VEHICLES(ACORD 101.Atldm oval P,cmzrk,Schedule,—y be an.chetl.t mnrr•soace�_re oc��red) `?fir ence of Coverage R, itF„J rlFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIPITION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. L�rt Builder- SerC GfOUp, Inc. A TOp BUi Id Company JAUTHOR1Z11111EPIESENTATVVE 760 Jimmy Ann Drive t,G Daytona Beach FL 32114 USA 01983-2014 ACORD CORPORATION-All rights reserved. )RD 25(2014101) The ACORD name and logo are registered marks of ACORD r F , j i i F t t f i t • � nFntlile i �,n�,U Oc t'�li•.: `�l�r: �the ��T, RIC CARD SCHWAR 1 L 19S FICINTRESS S"t"t2ECT f4:attetrtistrt t�tEt (1.3102 09126/2016 ReStrictecf J'o: C:SSt.-IC..lnsuiation Contr,rcror Failure to possess a current edition of the Massachusetts State(Building Code is cause for revocation of this license. it �t�1t''f1'•c'/��'l �' Office of Consumer AlEirJsfj nd�r'Busin'' ess Regulation 10 Park Plaza - Suite 5170 .Boston., Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 179141 Type: Supplement Card BUILDER SERVICES GROUP, INC. Expiration: 6/25/2016 RICHARD SCHWARTZ 110 PERIMETER RD NASHUA, NH 03063 update Address and return card.Mark reason for change. Address Renewal Employment Lost Card SGA ' l!r• 1`_'flaya ».�:;;y;I/,�r/t" _t>r;.,..ur1.;..i/f. ,.,t)flice of t"onsumcr Affairs&Business Regulation License or registration valid for individul use only SME IMPROVEMENT CONTRACTOR . r l before the expiration date. If found return to: •P Office of Consumer Affairs and Business Regulation '32egistratioa: 179141 Type %>; it?Park Plaza-Suite 5170 Expiration: 6/2512016 Supplement Card Boston,MA 02116 BUILDER SERVICES GROUP, INC. RICHARD SCfiiWARTZ - 260 JIMMY ANN DRIVE __......... . DAYTONA BEACH,FL 32114i! _ ndersecresary trot validiwithout signature