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Home My WebLink AboutBuilding Permit #525-13 - 730 MASSACHUSETTS AVENUE 1/22/2012TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other S p ick s Welly 1Floodplain Wetl�ands� _ Wate shed DESCRIPTION OF WORK TO BE PREFORMED: i rf� )rrt rM� 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 Cos X_7 . FEE: $ Check No.: Receipt No.: C� (;° to NOTE: Perso ontracting with unregistered contractors do not have access to the guaranty fund I . A Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL - Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT 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 Conservation Decision: Comm Water & Sewer Connection/signature & Date Driveway Permit DPW Town Engineer: Signature: 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 - Date Doc.Building Pernut Revised 2008 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 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/Crossection/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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Location7?,7y .— �" Date No. • TOWN OF NORTH ANDOVER 0 c^�,�1tr:D legs' • • Certificate of Occupancy $ Building/Frame Permit Fee $� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # R? 26104 Building Inspector next step dying This agreement is made by and among Michael Ryley .730 Mmachw tsAve North Andover MA 41545-4504 Customer ID: 000000104175 Site ID: 9002094145 Step t.hdrbg,, Mc. ('NSL"l 21 Drydodc Avenue 2°" fba Boston. MA02210 Coatmet ID: 20121121 ASNAL. 1. DESCRFnCN OF WORK TO BE NBLO W(w or cameto be psrbi. the lblim Arl wmk on the abnets adclan above, Ina pcimbial warmer end iri actxs�arroe wNh Obe tetbra of M CMftc , kftft the dadred awneriMmANA order descdbinglie work M Wal (the IAW whiCh are fncapoMM Webby MWMw Description Quarvw Location Door Sweep.. .. ... .......... 3. WA 563.51 Exterior Door Weather SbiQpir g WA $75.60 Perform Air SaIIr� at EsBrrbeted 62.5 C1:M5ti Per, Hour 24 ....- - Liyfr� S�aee $1,80.00 Sub Total: ' $1,987.11 . Net Safes Tex atter Incentive $0.00 Total $0.00 Prfnted:11121=2 Page 2 of 2 2. PAYMENT:fWSTOIRR agrees 0 pep MSL for the wo* as fol w Payme(#f: t V Credh Cid ar E-chackdeposit b due afBie fkne the Wak is t tb quirad paymerd Inform will be ootaded %w the q%e by a w tomer se ft reptesefbtelNe of the tlme oferdred�ng. b notio exceed 113 of Bre tots retalt cosh. Thb oonbatd Is rot N effect urdlitide depoeat lepaid by the Cut WM (Note MM to wl, Yba, and Dlswrerar= AddOabal Pgmwb and FhW Nv lm $ v Milaud paynb b falba Wark shall be due upon con ft of the Work Nov 23,. 2012' - Mifiecb Ryley (NYp 21 Date NSL S�rebbre �� Name of N& ReprasenWm The Tema of this Agreement we oor"ried on boar shies of Oft P w Next Sft Living 2i Dr)** Averme o 2w loa-floaon, MA 02210 ") W4M a rqIr com www.rbextsthp6virgfic cvm x ~ ui x LL o m u ++ o LL w+ N a LA o N z0 z J_ m C O + L.L. W ? C U _ LL F- N ? z D d. L � LL o y Z u W r Q' U U_ � (n _ m LL v a vi z Q d' LL ~ W o~c w W m O Z v — ln +' o o Ln 4wo 004 I� N r - 'r co W LOW O V co F- D. Rf . O .. C r (~� V W i .QL .a O n.ar 'U `° z E i :mQ �O �• . Z W :O0 p �+ O �' J Z Q 0 o .oc ~• �� •c a Z�.- � O�� L 0� .�mm M a F- Q- � E co O +� a ZH t c�� _ m d e° W O _ �. .• 0.-0 > a� 4� v G O V z CL LLI 3 t,>o c W J v vJ ) F- -0 a.Z CLO Q. Q- m '� N Z V m co C d v Q. $ U) 0 V y o = c _ m Q a) � U) v a) c 'a 0 0 a w c 0 CL •Q 0 N N , ZO _ 0 Q. 0 y o O t S C.ov > 1!1!ob��2Ll� Office of Consumer Affairs and Business Regulation 10 Park Plaza -Suite 5170 Boston, Massachusetts 02116 Dome Improvement Contractor Registration NEXT STEP LIVING INC. CLAYTON SCHULER 21 DRYDOCK AVE. 2TH FL BOSTON, MA 02210 SCA 1 Co 20M•05/11 �.e ipaNvnra�uuaul� a�C�/%i�.craaa��cec:�a Office of Consumer Affairs do Business regulation U�- ,AME IMPROVEMENT CONTRACTOR egistration: .162111 Type: xpiration: 1/14/2015 Private Corporaticn NEXT STEP LIVING INC. a . F - CLAYTON SCHULER - 21 DRYDOCK AVE. 2TH FLM 4_ BOSTON, MA 02210 Undersecretary Registration: 162111 Type: Private Corporation Expiration: 1/14/2015 Tr# 234949 t , Update Address and return card. bark reason for change. Address [] Renewal Ej )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 t Massachusetts - Department of Public Safety Board of Buildllng Regulations and Standards Constructi(m Supxviwr Specialty License- CSSL-102811 ROGER ADVELLIETTE 55 STANMORE ROAD Warwick RI 02899 ti Expiration Commissioner 09/13/2014 Restricted To: CSSL-IC - Insulation Contractor Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS NEXTS-1 OP ID: BS CERTIFICATE OF LIABILITY INSURANCE DATE(1/09/ 2. 11!09112 . 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 Phone: 781.665-2775 McLaughlinInsurance Agency Fax:781-665-0295 828 Lynn Fells Parkway Melrose, MA 02176 John E. McLaughlin Jr. CONTACT NAME: PHONE FAX Arc o Ext): ac No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE_ NAIC # INSURER A:OneBeacon Insurance Group 11111113 INSURED Next Step Living, Inc. Mr. Brian Greenfield 21 Drydock Avenue, 2nd Floor INSURER 13: Hartford Insurance Company 19682 INSURERC:A.I.M. Mutual Insurance Co. PERSONAL & ADV INJURY $ 1,000,000 Boston, MA 02210 INSURER D: INSURER E : PRODUCTS - COMP/OP AGG $ 1,000,000 INSURER F: A nnvcaancc rFQTII_IraTF PJHMRFR- 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 N D POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYWY LIMITS, A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ® OCCUR 7920005600001 11111/12 11111113 EACH OCCURRENCE $ 11000,00 PDAMAG5 TO RENTED REMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 1,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS. X HIREDAUTOS X NON-OWNEDPeoaccidenDPER AUTOS 3900012090001 11111112 11/11/13 Ea eBcl,den SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ AMAGE $ $ A X UMBRELLA LIAB EXCESS LIAB HCLAIMS-MADE OCCUR 7920005610001 11/11/12 11/11/13 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,00 DED I X I RETENTION $ $ C WORKERS COMPENSATIONWC AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICER/MEMBER EXCLUDED' (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA TO BE ISSUED BY CARRIER 11111/12 11/11113 STATU- OTH- X TORY LIMITS ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 E.L. DISEASE -POLICY LIMIT $ 500,000 A Property 08UUMHX5486 11111112 11111/13 BPP 1,033,89 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Office IC INFO -01 For Information Only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES.BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U 1988-ZUIU AGUKU GUKt'UKA I IUN. An ngnis reserves. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT IFICAT'E ®F LIABILITY INSURANCE i'�'�11/12/2012 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 John E McLaughlin Insurance Agency LLP 828 Lynn Fells Parkway �,/�A ry Melrose, MA 02176 CONTACT PHONE FAX (A/C. No. Ext): (A/C. No): E-MAIL PRODUCER PRODUCE CUSTOMER ID#. INSUREDS) AFFORDING COVERAGE NAIC # INSURED Next Step Living Inc 21 Drydock Avenue Boston, MA 02210 INSURER A: A.I.M. Mutual Insurance Co 33758 INSURER B: INSURER C: INSURER D: 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 NAKED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. issPOLICY TYPE OF INSURANCE NUMBER POLICY JEFF POLICY EXP _ LIMITS GENERAL LIABILITY EACH OCCURANCE S COMMERCIAL GENERAL LIABILITY Fl[]CLAIMS MADE OCCUR DAMAGE TO RENTED - $ PREMISES (Ea. occurrence) MED EXP (Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES ER: PRODUCTS - COMP/OP AGG $ ❑ POLICY PROJECT ❑ LOC AUTOMOBILE LIABILITY RANY AUTO ❑ALL WINED AUTOS COMBINED SINGLE LIMIT $ (ea accident) BODILY INJURY (per person) $ , BODILY INJURY(per accident) $ ❑SCHEDULED AUTOS PROPERTY DAMAGE $ (per accident) ❑HIRED AUTOS RNON-OWNED AUTOS $ R $ UMBRELLA LIAB R, OCCUR EACH OCCURRENCE $ AGGREGATE $ [—]EXCESS LIAB ❑ CLAIMS NAD -c $ RDEDUCTIBLE $ ❑RETENTION $ - WORKERS COMPENSATION AND EMPLOYEES LIABILITY ® NC STATO- OTH- TORY canis I ER E. L. EACH ACCIDENT $ 500,000 THE PROPRIETOR/PARTNERS/ A EXECUTIVE OFFICERS ARE ® Incl ❑ eXCl 7025153012012 11/11/2012 11/11/2013 E. L. DISEASE -POLICY LIMIT $ SOO,000 E. L. DISEASE - EA EMPLOYEE $ 5500,000 COMMENTS / DESCRIPTION OF OPERATIONS OR LOCATIONS: WORKERS COMPENSATION COVERAGE APPLIES TO MA EMPLOYEES ONLY CERTIFICATE AATd1FR CANCELLATION PROOF OF COVERAGE _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE II EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY- PROVISIONS. �•� E AOTHORIEED REP RESENTAT IVC The Commonwealth ofMassaehusetts I. rrinrcorm I Department of Industrial Accident Office Of Invesidgadons A d Congress shvee9 suite log BostonMA ®21Y4 2017 www. assegov1d1a Workers'. Compensation Insurance Affidavit: Bufldeirs/(Conbractoirs/Electiricizns/IlDflat mbeirs Aleipll��>mt Information Rease Print I egLbll� NaMe (Business/Organization4ndividual)o Next Step Living Address: 21. ®rydoclt Ave Cfty/Stete/Zip: Boston, MA 02210 Phone #: (617) 850-9101 Are you an employer? (Check the appropriate box: 1. 1 am a employer with 400 4. ® I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ® 1 am a sole proprietor or partner- listed on the attached sheet. ship and have no employees 'These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp.. insurance comp. insurance) required.] 5. ® We are a corporation and its 3. ® 1 am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ® New construction I. ® Remodeling 8. ®Demolition 9. ® Building addition 10.® Electrical repairs or additions 11. ® Plumbing repairs or additions 12. ® Roof repairs 13.[D Other lnsulation *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. d annn aniera,plower that is providing workem" compenasationd inasuranace1for my employees. Below as the fpolley and �®� ske innform afdon. Insurance Company Name: AIM Mutual Insurance Company Policy # or Self -ins. Lie. Yob Site Address: 7025153012012 Expiration Date: 11/11/2013 City/State/Zip: 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 Head 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 IDIA for insurance coyeragc verification. i Il ado hereft a ertafr under the Phone #: ithag the dn&madox provl dedl above is &ue and correct O, fscaad use only. Do not write in this area, to Bre completed by city or town official. (City or Town: Permit/License # Issuing ,kuthorlty (circle one). 1. Board of ]Health 2e Building (Department 3. (City/Town Clerk 4. dElectridal Inspector 5. Plumbing Inspector 6. Other (Contact Person- Phone #o