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Home My WebLink AboutBuilding Permit #948-16 - 42 SARGENT STREET 3/7/2016BUILDING PERMIT & 0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 0"Ar.0 Date Issued: S CHUS IMPORTANT: Applicant must complete all items on this r)a2e LOCATION- 42 Sargent Street North Andover, MA 01845 t PROPERTY OWNER Marilenin Vasquez7tuis Diaz Print MAP NO: 018.0 PARCEL: 0056 ZONING DISTRICT: Historic District yes no Machine Shop Villaqe ves; no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building XOne family El Addition El Two or more family 0 Industrial XAlteration No. of units: 11 Commercial 0 Repair, replacement I] Assessory Bldg 11 Others: 11 Demolition 11 Other El Septic El Well El Floodplain D Wetlands 0 Watershed District El Water/Sewer I — Air sealing, Install Q -Ion weatherstripping and doorsweep to 3 doors, Install 10" layer of R-35 Class I Cellulo)se to open attic Identification Please Type or Print Clearly) OWNER: Name: Marilenin Vasquez / Luis Diaz Phone: 978-853-0100 Address: 42 Sargent Street North Andover, MA 01845 CONTRACTOR Name: Endless Energy Address: 184 Cedar Hill St, Marlborough, MA 01752 Phone: 774-540-1544 Supervisor's Construction License: 108214 Exp. Date: 4/2/18 Home Improvement License: 174479 Exp. Date: 1/28/17 ARCH ITECT/ENGI NEER 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: $ 1952.32 FEE: $ 30.00 Check No.: ReceiptNo.: NOTE: Persons contracting with unregistered contractors do not have access to tte guaranty I re ot Agent/Owner a-.xA aCM-� Sicinature of contractor Plans Submitted 0 Plans Waived Certified Plot Plan Starn , ped-i-slans 11 TYPE OF SEWERAGE DISPO AL Public Sewer Taming/Massageffiody Art Swimming Pools well El Tobacco Sales El Food Packaging/Sales El Private (septic tank etc. Permanent Dumpster on Site. El THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM I PLANNING & DEVELOPMENT COMMENTS Reviewed On Signature', 4 HEALTH Reviewed on Signature COMMENTS Zonrng Board of Appeals: Variance, Petition No: Zoning Decisionlreceipt submitted yes Plan-'ning Board Decision: Comments Conservation Decision: Comments Water & Sewer ConneGfloni Permit DPW Town Engineer: Signature: Locatea ;jb4 usgoocl Ijtreet -A UsTIA eNT, Qurii0§t6r- 6n,-,s1t6.-.,-, :F.IR :-'bE-IJJ)`-k:1 ------ "'J", e1mp IT I.; a -Mr, I F1 en j�jg Ne P ature/datp)�w R , % t , ` P 'N aT 11n re 10, rl'* i�min 5t0e WW"', "U� jytj�3,4'v K/ EN T C Dimension Number of Stories: Total square feet of floor area, based I on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movernent.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 rnin.sl 00-si 000 fine Doe.Building Permit Revised 2014 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 4� Building Permit Application 4� Workers Comp Affidavit ,L- Photo Copy Of H.I.C. And/Or C.S.L. Licenses 4� Copy of Contract 4. Floor Plan Or Proposed Interior Work rt. Engineering Affidavits for Engineered products OTE: 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) - Eng . in . eer . in . g . Aff . id - av , i . t . s - fo . r - E - n- g-i'n- - 6 e r e- d- pr- 6 d Oct § TE: 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 Engineering Affidavits for Engineered products 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 Doe: Building Permit Revised 2014 C\ rA LL 0 0 r_ (v _r_ u -0 0 0 E a) — In Ln CL 0) 0 LU 0. fA z z M co r_ .2 co _0 0 LL to :3 0 >. 0) E U LL I 0 LU IL kA z D -i w 0 CC U- 0 u LLJ CL (A z LU to 0 Q) u cu V) c 1 U- cc 0 u LLJ z -C to =3 0 U- z LU 2 uj LLI c ca 6 Z CU a) — Ln E Ln 0 cc CL 4) M= cn 0 E 0 'M U) 44 — S 4) m 4) 0 0 A.' E ED ..0 S 02 0 U) CL Cc 0 02 U) co e, > Cc 4) (n 4) C > 0 co 0-0 Cl) C) 4) 0 z dMoo: U) a U) 0 4 A tm > 0 CL 4) CL 4) 4) r_ t3) 0 4) L- : 12 cc -0 4) 4) — CL 6's U) 4).2 co m = r - UJ -0— 0 0 2 Lu -;; cn c CL 0 uml L LU E ti 4) 0.0 4) 0. w M 0 cc o " c 0 Z5 CL 0 (-) 0 Cl) Z 0 co Cl) z 0 Cl) E MA U) uj 0 > CO) z a x 0 LLJ 0 L) U) U) w —j Z 0 E 0 0 z 0 0 Clb a 9 �j 0 E 0 z 0 01- 0 0 cc o CL CL CL U) CF) 0 Cc Cc CL 0 c 1) z c 0 CL L) cc www.ametleaninsullations.coin Endless Energy How Performance Contractor 184 Cedar Hill 84 Marlborough, MA 01752 CONTRACT 77"411-115" FAX 401) 784-3710 Pogo 1 PROGRAM CNIA-HPC CUSTOMER PWME DATE CLIEW 9 WM ORDER Mardenin Vasquez (978)853-0100 12/08/2015 425308 00001 SERVICE STREET SILUNG STREUr 42 Sargent Street 42 Sargent Smet ISERVICE CrrV,.qrATA ZIP eILUNG CITY, STATE, VP Nordi Andover, MA 01845 North Andover, MA 01945 JOB DESCRWTION AIR SEALING: Provide labor and materials to seal area% of your home against wasteful, excess air leakage. This work will be perfonned in concen with the use of special tools and diagnmtic tests to assure that your borne will be left with a healthful level of air "change and indoor air quality. Materials to be used to seal your borne can include caulks, foams and other products. Mmary arms for scaling include air leakage to attics, basements. attached garagm and other unheated arm (windows are not generally addresmA.) (8) working hours. A reduction in cubic feet per minute (cfm) of air infiltration will occur, but the actual number of cfm is not guaranteed. At the completion of the weatherization work, and at no additional cmit to the. homeowner, a final blower door andbor combustion safety analysis will be conducted by the sub-cmtractor to ensure the safety of the indoor air quality. $680,00 AIR SEALD;G: Provide labor and materiath to install Q -Ion weatherstripping and a doorswccp to (3) door(s) to res. trict air leakage. sl,)5.00 DAMMING: Provide labor and materials to install a 12" layer of R-38 unfaccd fiberglass baits to (24) square feet for danuriing purposes. $49.20 ATTIC FLAT: Provide labor and materials to install a 10" layer of R-35 Class I Cellulose added to (540) square feet of open attic space, $793.80 AWIC ACCESS: Provide labor and materials to install (1) new, finished plywood, with 2" rigid Thcrmax bowd. weatherstripped attic space access batch. Prime coal and/or paint is not included. $115.00 CRAWLSPACF: Provide labor and materials to install (116) squaric feci of 6 ml polyethylene over open ground in dcsignalod crawlspacefearthen basement areas. S89.32 www.americanin3%llatlons.com Endless Energy Honw Performance Contractor 184 Ceder Hill St, Marlborough, MA 017S2 CONTRACT 774-540-1544 FAX (401) 784-3710 Page 2 PROGRAM CMA -HPC CUSTOMER PWNE DATE CLIENT I WORK ORDER Marilenin Vasquez (978)853-0100 12/08/2015 425308 00001 SERVICE STREET BILLINO STREET 42 Sargent Street 42 Sargent Street SERVICE CITY, STATF- ZIP BILLING CITY, STATE, ZIP North Andover, MA 01845 North Andover, MA 01845 JOB DESCRIMON Total: $1,952.32 Program Incentive- $1,634.24 Customer Total: $318.08 WE AGREE MEREBY TO FURNISH SERVICES - COMPLETE IN ACCORDANCE WITH A13OVE SPECIFICATIONS. FOR THE SUM OF ***Three Hundred Eighteen 11108/100 Dollars $318.08 A —; Z ILIT 1AWSKINATtAf- "Im 0 A14CE V NOTE: THIS CONTRACT MAY BE WITMRAWN BY US IF NOT EXECUTED WITHIN D EOF PtANCE OAYS, Endless Energy www,americanirksullaitions.com Honte Perfornmee Contractor 184 Cedar Hill St, Marlborough, MA 01752 CONTRACT 774-540-1544 FAX (401) 784-3710 Page 2 PROGRAM CMA -HPC CUSTOW!" PHONE DATE CLIEW 9 WORK ORDER Marilenin Vasquez (978)853-0100 1-2/08/2015 425308 00001. SERYM 8TA9V RIWNG SMUT 42 Sargent Street 42 Sargent Street S9RVICE CrrY, $TATF, ZIP BILUNG CrrY, STATC ZIP North Andover, MA 01845 North Andover, MA 0 1845 JOB DESCRIMON Total: $1,952.32 Program Incentive* $1,634.24 Customer Total: $318.08 WEAGREE MEREBYTO FURNISN SERVICES- COMPLETE IN ACCORDANCE WrrH ABOVE SPECIFICATIONS. FORTHE SUM OF ***Three Hundred Eig�teen & 08/100 Dollars $318.08 A S7110N1ATURf-.WI4W" no -E 0 EFTAWNCE NOTE; 7HIS COWRACT WAY AE Wn'MORAWN By US IF NOT EXECUTED WITMN 71F D EOF EFrANcE OAVS. I PERMIT AGENT AUTHORIZATION FORM ALL INFORMATION IS TO BE TYPED OR LEGIBLY PRINTED do hereby authorize the company or contractor, selected by Endless Energy*, to obtain any and all necessary building permits at Permit Authorization obtained by Endless Energy Homeowner of Above Listed Address: eName signed) if�7- (Name Ptinted) Endless Energy Representative: "OL�JziEe� W (toe 619ned) Sf Alict4 7 7FT—ei6nt�c — (Name PMWd) This form supersedes any previously submitted letter(s) of authorization. *Endless Energy retains the right to select the contractor based on availability, location, and affiliation with the MassSave program. This form must contain only the people you want to pull permits in your name. To make changes to this forrn, you must submit a new form. This form will delete and replace any previous authorization form and the information contained thereon. The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 wwwmass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Endless Mountains Solar Services Address: 288 Kidder St City/State/Zip: Wilkes Barre PA 18702 Phone #: 570-820-5990 Are you an employer? Check the appropriate box: Type of project (required): FEI I am a employer with 10 4. E] I am a general contractor and 1 6. F-1 New construction 1 11 Al have hired the sub -contractors, emp oyees � an or pal t- el. I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 1 am a homeowner doing all work myself [No workers' comp. insurance required.] t listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.: 5. We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comv. insurance required.] 7. E] Remodeling 8. Fj Demolition 9. F� Building addition 10.0 Electrical repairs or additions ILE] Plumbing repairs or additions 12.F1 Roof repairs 1AN Other Weatherization *Any applicant that checks box #1 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 insurancefor my employees. Below is the policy andjob site information. Insurance Company Name: HDI -Gerling America Inc Co. Policy # or Self -ins. Lic. #: 000087615 Job Site Address: 42 Sargent Street Expiration Date: 5/9/16 City/State/Zip- North Andover/MA/01845 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 NIGL 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 certify under the pains andpenalties ofperjury that the information provided above is true and correct. Si,P_natqfj2)Z�2 d4 t7�7� )d Date: 2/05/16 5708205990 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#: a AC40RD� CERTIFICATE OF LIABILITY INSURANCE liii-� DATE (MM/DD1YYM 1 1/25/2016 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(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 Sharon Zaccone -NAME:--- - - (570)819-2000 FAX -4000 M. Ext), (AIC, Nol: (570) 819 Eastern Insurance Group E-MAIL,,,. ADDRE szaccone@easterninsurancegroup.com 613 Baltimore Drive INSURER(S) AFFORDING COVERAGE NAIC # INSURER A -JiDI-Gerlincr America Ins Co 41343 Wilkes Barre PA 18702-7980 INSURED INSURER B: INSURER C: Endless Mountain Water Services, LLC, DBA: Endless INSURERD: Mountain Solar Services, DBA Endless Energy INSURER E: 286 Kidder St INSURER F: ,Wilkes Barre PA 18703 COVERAGES CERTIFICATE NUMBER:Master 15-16 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 TYPECIFINSURANCE ADDLSUBR POLICY NUMBER POLIC IMMIDDMI POLICY EXP (MMIDDNYYYI LIMITS I X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE Fx_]OCCUR A AGT' RENTED 'PREM MISES(E...."...) $ 100,000 MED EXP (Any one person) $ 5,000 EGG000087615 5/9/2015 5/9/2016 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- F ] LOC X POLICY JECT PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits Liability $ 1,000,000 OTHER: AUTOMOBILE LIABILITY MBINED INGLE LIMIT (CEO, .,d.n,)S $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS F.AGCCO00087615 5/9/2015 519/2016 BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PR ER DAMAGE OP Z er a d $ Medical Expense $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ -AGGREGATE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N 1 PER OTH ISTATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? F7 (Mandatory in NH) NIA EWGCCO00087615 5/9/2015 5/9/2016 E.L. DISEASE - EA EMPLOYE9 $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Proof of Insurance I I CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) INS025i2nuni� @ 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover, MA 01845 AUTHORIZED REPRESENTATIVE I Pharon Zaccone/SZ __-q ACORD 25 (2014/01) INS025i2nuni� @ 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD dTliv, lec�1))V?Ijrllf9l:�l"lt",(?,(,YI /,//?/ Offlc6 of Consumer Affairs id' 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home ImprovemOnt.,,.Contractor Registration ENDLESS MOUNTAINS SOLAR ERIC CHARTRAND 288 KIDDER STREET WILKES BARRE, PA 18702 SCA I Co 20M-Oatil � 7/10 of Consumer Affairs & Business Regulation IMPROVEMENT CONTRACTOR ENDLESS MOUNTAINS: SOLA ENDLESS MOUNTAINS'S Ou ERIC CHARTRAND 288 KIDDER STREET':%.:, WILKES BARRE, PA 18702 Type: Supplement Card 3VICES, LLC Undersecretary Registration: 174479 Type: Supplement Card Expiration: 1/28/2017 late Address and return card. Mark reason for change. [-_] Address [] Renewal U Employment [] Lost Card License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 Not valid without signature MassachuseiTs i5cara 0,,8u,;," a'c 04 "auooc saf ns et, --ens, CS -108214 EPJC CIM 394 ELM , RTRAND GOrdner STREEr A" 01440 f ;2- 7411-.,�- - CC-1-4ssione, 0410212018 27 Sanborn St Fitchburg MA 01420 978-652-2680 Location 41�4 S4 e -ht - U No. q��- Date Check # ;(V�� 3 d. a n C. Q U ", TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee Foundation Permit Fee $ Other Permit Fee TOTAL Building Inspector