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HomeMy WebLinkAboutBuilding Permit #1081-2016 - 97 APPLETON STREET 4/15/2016 BUILDING PERMIT TOWN OF NORTH ANDOVER ++ APPLICATION FOR PLAN EXAMINAT0,511 Permit NO: 1" Date Received �9SSAC HV SE��h Date Issued: IMPORTANT: Aeplicant must complete all items on this eae v , LOCATION PROPERTY O'ER t <. *-OWK CIT TYPE OF IMPROVEMENT PROPOSED USE Resid ntial Non- Residential ❑ New Building ne family ❑ Addition ❑ Two or more family ❑ Industrial L,4teration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg 71 Others: ❑ Demolition ❑ Other lasepte .: 0 s V-x s L"- (� Identification Please Type or Print Clearly) OWNER: Name: � L1' 1 til L..u ��-�'� Phone: Address: i-� L �1 S"I V� • !`\� e .O� l +� Q `�`S� CTRAT : . ��- St v 's Construc0on ase It,..' ARCHITECT/ENGINEER 6't 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: $ 5 � ! S� FEE: $ i�T 6 ' Q o 'Check No.: 116 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have s te-tli uaranty fund r atur of A tier nature 4 fact # nv�Y � Ate a-Q-4 Location No. ` l c (�?` Date . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ r(d; {� Foundation Permit Fee $ Other Permit Fee $ r. TOTAL $ Y i Check .. n /Building Inspector :t 25a i NORTH own of 0 . L_ No. � Z oLAKI h , ver, Mass, coc"Ic"t-1 K 1 U BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT Kcvuh. wi-dBUILDING INSPECTOR ....... . .......... wi - .. ................. .. ,.�. . . � Foundation has permission to erect .......................... buildings on ... .... .... ................ Rough to be occupied as A-fi .�..1+Ir. ..S.4 �+.. ..Lo-n. .......... Chimney ....... .............................. provided that the person accepting this permit shall 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 VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough dW .... Service ......... ... _ .. �,�..,. U'I "D'I"N"G"I"......"C"T". Final BUILDING INSPECTOR 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. ,1 RISE60 Shawmut Road,Unit 2 Canton,MA 02021' 339.602.6335 ENGINEERING www.RlSEengIPeering.com Ef icienv)Ene.gized. OWNER AUTHORIZATION FORM I Kevin Lundy , (Owner's Name) owner of the property located at: 97 Appleton Street, North Andover, MA 01845 (Property Address) (Property Address) hereby authorize (Subcon ctor) 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. Owner's Signature VT- Date yFederal ID#95,0495825 Cordracw P&qMraftn No 86 MA dv Registrabn No812W9 RISEAdivisionofThlelsebEngineering cTContractor t tralJOntfo829120 1GlNl� 60 Showrtut,Canton,MA 0=1 CONTRACT 334-5{i7.�i97 F+ 334St32.634'5 MJtAM oommM atrouffrolm ME ii��+ GMA'"I�.S swa�cr+s Mr suers «t�tr. KevinLUDdy °' ; (61'W9-5493 01 0l20i6 428877 t 13002 97 Appleton Sheet ,,, 97 Appleton Stred c.� at a C",WAM VP q7 NAM CM.8rAMZW North Andover,MA 01845 North Andover,MA 01945 DucRiPnoN A1R SBh1 ll+tt3:Provick labor and ntatefals to seal areas of year home t arastelill accts air l kage This work wnl be perfused in conom writh the use of'special tools and di Mosdc fiesta to assm dna!your]name will be tett with s healthful level of air excharq t and indoor air qas ty.lvlatedds to be used to stal your home can include caulks,foam and other products. t'rtmwY areas for scaling include air leakage to attics,basements,atmched prAp and other unheated arae(windolvs arc not generally addressed.)This will"One(8)working hours, A redaction in cable feet per ming(ofm)of air infiltrldiou vr11 occur,but dm aeras]number of coin is not guaranteed. At the completion of the mon work,and at no additional cost to the homeowner,a final blovrer door arultor combustion safety analysis will be ctmdamd by the sub-contractor to smear:the safety of the indoor air COWity. $480.00 AIR SEAL 40 ADDER: (2)working horns. $170.00 AM SPAl.1 a Provide labor and materials to WM l Q4M wcathastripping and a doom% p to(1)doors)to marmot air leakage. $75.00 DAM1o4 N&,Provide labor End materials to histall a 12"law of R 38 untheed fibagm bans to(132)square foes for datnmirrg ptupo�s. $270.60 AT nC FLAT:Provide lobar and mactials to install a 10"layer ofR-35{lass i Ceilulm added to(1380)square feet of open attic space. $2,028.60 APCCC ACCESS:Provide tobwcul materia to insulate ft lack of(1)atfic betel{with 2"rigid Thttmmr M.Weathtrs*the perimitur. $60.00 VPN7 iLAt noN:Provide labor and materials to install(1)insulated exhaust hose with roof mounted flapper vont to eodtaust fisture batbmom fmm(s). $118.75 Vtiidl'll,A►'110N.ftovide labor and tnatuxials to install vtsttilation chutes cn(63)MM-M—to iiaintain air flow. $126.00 BA,SEM4T CED2t(3:Provide labor and modals to imstall(120)linear fees of R•19 unlaced fcbaglasa ims"On to the pier of the basement oeitimmg at the house sill. $210.00 RISE Fuenteringwitl apply all applicable,eligible incentives to this contract. You will only be btu the Ne(amatmt. CVrtently>for eligible: meagm Columbia{alas offes M utoenM riot to exoted$2,000 per calvA r year,and an in tttivc of 10Wa for the:Air Sealing Memues up to Ut first$680 aril an adMiotal$340 if savings are justified by the auditor. For Ute safety and health of your home's indoor air Wity,we will be conducting s blower door diagnostic of the available air flow in your home both before the work is began,and after the wealheriration work is Complete.We will also ooncluct a full assessment of the oombwftn safety of your heating system and water heater.This has a value of$90 and is at no cost to you. Total allowable meri6ti0n incentive is$3,110. ID#0544O029 R><SE ; ueeri Pj Cs #acb ®r RtgtstrBt100 NO 9186 NO 1179 RISE A diVWOG Off tntlscb Water g CT Contmc� 29No 6291120 6994alymet,Canton,MA02021 CONTRACT 339-5t} 1 7 FAX 333-502.6MS pap 2 PROGRAM CNA-WS Kevin Lundy (617)25'-5493 0112001 b 428877 00002 tmvm STRM s um slltmr 97 Appleton Street 97 Appleton Street BEM=:W.sT,4mzw mumCrrt,9TATE,+9P North Andover,MA 01845 North Andover,MA 01845 JOB DESCRR''1'TON Total: $3,828.95 Program incentive: $2,940.00 Customer Total, $88 m WE AGM KWM TO FURNISH SEWCES•COMPLEtE 1N ACt.DtZtlANCE W"ABOVE Snetl`="ONS.FOR THE SUM 6F 'Eight Hundred Eighty-Eight&951100 Dollars $888,95 �}pppi PRiAI. ANDAPPAtQVA16Y'815E El1OINECitifl6.CtkSTOi1612 AGSTOrAH1O7111'rP11iL.R7[@AE51-oP t7c � uNaAaa A�Rib0AY8�P �tnavatraaT O41 61)ARA61Pf:�Rt66TiiOf151.8CifEAULiNG. a GO NOT WN TIM COUMCT W THE3'tE ARE ANY t3LMX SPAM AVfltiSRl�9iBtiA -RBtEemhmus NOTE;rA%CONMCT MAY BE WAWA"By IS W NOT E1ad1ri<S Wrr" DA'TE OF ACCt�TANCL- ACCEP'fAl1LE OF 6'ONTRACT•TFC A>1aYt:PR3tt�.6P'd9G1CATit ASST CbtiglY101B ARB 30 SATAtiPA4:rORY TO Iffi AND ARE.NB2E9Y ACtA:fi1E9.YOU AWE1Wri[ TO db TtiE WORK DAYS. A8 5PC-QFYE31,PAYME1ilT Wf3.2. i'w#1%E A6 dt1YWN66 ABOVE ACC)MY DATE(MWDD/YYYY) �..- CERTIFICATE OF LIABILITY INSURANCE 11/12/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), 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 James J. Dowd & Sons Ins NAME: Debbie MacNeal PHONE FAX 14 Bobala Road AIC No Ext: - - AIC No: Holyoke MA 01040 E-MAIL ADDRESS: dmacneal@dowd.com PRODUCER CUSTOMER ID#o COOP INSURER($)AFFORDING COVERAGE NAIC 4 INSURED Co-op Power, Inc. INSURER A:HDI-Gerlin America Insurance Compa 15A West Street INSURERB:TOrus National Insurance Company 25496 West Hatfield MA 01088 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:254565886 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. NOTWTHSTANDING 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 ADDL S BR LTR TYPE OF INSURANCE IN POLICY NUMBER POLICY EFF POLICY EXP A GENERAL LIABILITY EGG000001 LICY llt/8/2015 JM IDD LIMITS EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY q PREMISES Ea occurrence $100,000 CLAIMS-MADE X OCCUR MED EXP(Anyone person) $5,000 PERSONALBADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PROPRODUCTS-COMP/CPAGG $2,000,000 X POLICY - LOC $ A AUTOMOBILE LIABILITY EAGCC000187715 11/8/2015 11/8/2016 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY(Per person) $ X SCHEDU LED AUTOS BODILY INJURY(Per accident) $ X HIREDAUTOS PROPERTY DAMAGE $ X NON-OWNED AUTOS (Per accident) Comprehensiv $ B X UMBRELLA UAB OCCUR 70354QISOALI 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 $ EWGCCOOOI87715 11/8/2015 11/8/2016 YTATU- OTH- ANDEMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PXCLUDEDxECUTIVE E.L.EACH ACCIDENT $1,000,000 (MandaLIMITS FIR tory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate Holder, Eversource, and National Grid are Additional Insureds on a primary and non-contributory basis per written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED CLEAResult IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Contractor Services Dept. 50 Washington St. AUTHORIZED REPRESENTATIVE Westborough MA 01581 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD 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.® 1 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 ]0.❑ 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 12.0 Roof repairs insurance required.]' employees. [No workers' 13.® OtherScomp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. 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.#: EWGCC0001817715 Expiration Date: 11/008812,0116 c. Job Site Address: C (� City/State/Zip: Ail ' 17�W1��/,,/V►�1"r-� 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify undergr agins and penalties of perjury that the information provided above is true and correct. Si nature: cc Date: ^f/ Pho e Official use only. Do not write in this area,to be completed by city or town official. City.or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: / f Office of Consumer Affairs and Business Recrulation 10 Part: Plaza - quite �1.70 Boston, Massachusetts 02116 Home ImprovementContractorRegistration Registration: 165217 Type: Supplement Card r; Expiration: 1121/2018 CO-OP POWER, INC, DEAN DANIELS � ___.__.. _... _____ .........._.. 15A WEST ST �: . WEST HATFIELD, MA 0108$ , Update Address and return card.;!lark reason for change. SCA 0 20M-r, Address Renewal .-J Employment Lost yard r1 ._ilsr r.t.r r•tl €fico of t onsumer Affair-&Busine"Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation ` y 9 1.0 Park Plaza;Suite 5170 Registration: 165' Type: �y Expiration: 1/21,x ,18 Supplement Card pp Boston,MA Otl 16 CO-OP POWER,INC. LEAH DANIELS 15A WEST ST ._. WEST HATFIELD,MA 01088 ,._ Undersecretary Not valid without signature Massachusetts Department of Pudic Safety 1 Board of Building Regulations and Standards � License: CS-097409 Construction Supervisor LEAN M DANIELS 12 MARCELL.A ST ROX13URY MA 02119 • � Expiration. C;om"missioner 0511812017