HomeMy WebLinkAboutBuilding Permit # 2/25/2015 NORTH A-
UILDING PERMIT oFJ.(LFD ,gq'�o
TOWN OF NORTH ANDOVER �� .6 °�
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APPLICATION FOR PLAN EXAMINATION _
Date Received '° -7 QDRATED
Permit No#: � �v �
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Date Issued: ��� ���
IMPORTANT: Applicant must complete all items on this page
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P/ OP,ERT�Y OWNER, ii rrrr„
TYPE 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
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❑ Septic ❑Well r ❑ Floodplain; UVe n ed District
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DESCRIPTION OF WORK TO BE PERFORMED:
Ide tificatio - Please Type or Print Clearly
OWNER: Name: ��(l' )C l Phone:
Address I (� A/
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Contractor Name Phone
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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 Cost: $ FEE: $
Check No.: � Receipt No.:
NOTE: Persons contracting with it " is contractors do not have access to the n f
Izd
Signature of Agent/Owner ignature of contractor
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U BOARD OF HEALTH
FERMI D Food/Kitchen
Septic System
THIS CERTIFIES THAT ......... .... `Ilk Ne. t C 1 BUILDING INSPECTOR
....... .......... .. .....
.... ...........
.. .............. . ..............
•eI� �`I� ' Q • Foundation
has.permission to erect .......................... buildings on ......... .........................................................
`.1 k
Rough
$o be occupied as .... .. ............................... . .-.........'.... ...................................................... Chimney
provided that the person accepting this ermit sT1�AI in eve res respect conform to the terms of the application p p p g p � p pp 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
Service
..............P4.... .. .. . .�...�..�.............................. 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.
n ex t s t le p 1.1 V g
This agreement Is made by and among
Next Step Living,Inc.("NSL")
Christine Duci 21 Dryclock Avenue,2nd floor
Richardson Ave Boston,MA 02210
North Andover, MA 01845 phone: (866)867-8729
Site ID: A583377
11-Dec-14
1. )ESCRIPTION OF WORK TO BE PERFORMED
NSL will perform or cause to be performed the following work on the customer's address above,in a professional manner and in accordance
with the terms of this Contract,including the attached recommendations/work of-der describing the work in detail(the"Work")which are
incorporated herein by reference:
ME
Work Location: Attic Flat
Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 2 $75.00 Hr $150.00
Work Location: Foundation
Insulate Rim Joist with 6.25"Fiberglass Batting 164 $1.75 Lnft $287.00
Work Location: Doors
Door: Thermal Barrier Polyiso 2"(Attic) 1 $73.91 Each $73.91
100%Airsealing Incentive up to Program Max $150.00
75 % Weatherization Incentive up to Program Max $270.68,
g illiiiiiiillmg�!! ill go I �
Estimated Annual Energy Savings from the Above Improvements $64.00
2. "AYMENT. CUSTOMER agrees to pay NSL for the work as follows:
Payment#1: $90.23
-Credit Card or E-check deposit is due at the time the Work is scheduled. Required payment information will be collected over the phone by a customer service
representative at the time of scheduling. Deposit is not to exceed1/3 of the total retail costs. (Note:Mastercard,Visa,and Discover accepted)
Additional Payments and Final Invoice: $0.00
-Additional payments for the Work shall be due upon completion of the Work.
If the final invoice is being paid by check,credit card information will still be required at the time of scheduling. Notify the customer service
representative that you are paying by check and your card will not be charged unless we fail to receive payment within 5 days of invoice.
c t i r l (if i e<'L x: !jI I Dec 11, 2014
Customer Signature Date
T17L 7r,F�_11171 T'1,7 711�"T 1 11 Dec 2014 DeborlabirlFw1lartim-nulder
NSL Signature Date Name of NSL Representative
The Terms of this Agreement are contained on both sides of this page
Next Step Living o 21 Drydock Avenue„2nd floor=Boston,MA 02210 (866)867-8729 ,inquii,y@tiextstepliviiiginc.coin>www.nextstepliving.com
TERMS OF AGREEMENT
3. PROPOSED START DATE AND COMPLETION SCHEDULE
NSL will contact customer to schedule the Work at a mutually agreeable time,subject to the availability of subcontractors or materials,or to delays
attributable to the weather or other events beyond NSL's control.
4. CONTRACTOR REGISTRATION
Massachusetts law requires home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor
Registration. You may inquire about contractor registration by writing to Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite
5170,Boston,MA 02116.617.973.8700.
5. PERMITS
NSL will obtain any necessary permits as the Customer's agent. Customers who secure their own permits or deal with an unregistered contractor will be
excluded from the Guaranty Fund provisions of the Home Improvement Contractor Law.
6. PERFORMANCE OF THE WORK AND CHANGES.
6.1 NSL will not commence the Work prior to signing this Agreement and transmittal of a copy of Agreement to the Customer
6.2 This Agreement may be supplemented,amended,or modified only by the mutual agreement of the parties.No supplement,amendment,or
modification of this Agreement shall be binding unless it is in writing and signed by all parties.
6.3 At times,our weatherization team discovers situations in the structure during the course of the Work that indicates a risk for a health or safety concern
for residents.Such concerns can include but are not limited to ventilation,potentially hazardous materials such as mold or asbestos,or structural
concerns. In the case of health or safety concerns being identified,NSL reserves the right,per section 9.2 of this contract,to communicate concerns to
the Customer and halt work until such concerns have been addressed.
6.4 The rebates and incentives available from the Mass Save®Home Energy Services Program and amounts due from the Customer are based on the
best estimate of the situation in the structure by the NSL home energy advisor. However,at times our weatherization team discovers situations in the
home during the course of the Work that impact the availability of rebates and incentives from the Mass Save Program. In such situations,NSL will
communicate such changes to the Customer,including any impact on amount the Customer would be expected to pay for the Work. The Customer will
have the option to remove from the Contract the work elements that need adjustment,or set up a separate contract for performing the adjusted work.
6.5 NSL represents and warrants to the Customer that(a)the materials and equipment furnished under this Agreement will be of good quality and new,
(b)that the Work will be free from defects,and(c)that the Work will conform with the description of the Work described in Paragraph 1.
7. INSURANCE AND REGISTRATION
NSL represents and warrants to the Customer that it has a valid Home Improvement Contractor Registration(No:162111)and the necessary insurance
required by applicable law and normally maintained by prudent contractors in NSL's field,including,but not limited to,Workers Compensation Insurance
for all employees who will perform the Work.
8. QUALITY OF WORK.
NSL agrees that the Work will be performed in a good and workmanlike manner,and that NSL will repair and replace,at its own expense,and promptly
upon Customer's request,any defects in workmanship and materials provided by NSL which appear up to(1)year after completion of the Work or within
any longer period as permitted or required under applicable law,provided NSL has received final payment as provided herein.
9. PRE-EXISTING CONDITIONS&PROPERTY PROTECTION
9.1 NSL shall not be responsible for any damages as a consequence of the Work performed in the home due to pre-existing conditions. These conditions
include but are not limited to poorly fastened or broken drywall,moisture damage,non-code construction,cracked or fragile siding or shingles,old pipes
and fittings,rotting wood,etc.
9.2 NSL reserves the right not to perform Work upon the discovery of asbestos,mold,or any other potential health risk to the Customer. In this event,the
Customer is responsible for remedying the at-risk situation,including any necessary removal of hazardous materials and all bills for services to date shall
be paid immediately. Work cannot resume until remediation is complete.
9.3 While NSL will make best efforts to protect any property of the Customer, it is the Customer's responsibility to remove or protect,including dust
protection,any personal property including the home itself. NSL will not be responsible for damages to or losses of any of the above mentioned property
not property protected prior to the commencement of the Work.
10. GENERAL PROVISIONS.
10.1 NSL reserves the right, the extent permitted by applicable law,to have,file or maintain a mechanic's or material men's lien,or to file a notice of
intention to lien,and to take any other steps to perfect and enforce such a lien,if Customer fails to pay NSL as provided herein.
10.2 This Agreement shall be construed in accordance with the laws of the Commonwealth of Massachusetts.
10.3 This Agreement forms the complete integrated agreement between NSL and Customer. The parties represent and warrant that in executing this
Agreement,they are not relying on any representations,warranties or terms other than as expressly contained herein. This Agreement supersedes all
prior agreements between the Customer and Contractor and may not be altered absent a subsequent written agreement signed by both parties.
You may cancel this Agreement if it has been signed at a place other than the NSL's normal place of business,provided you notify NSL in writing at its
main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing
of this Agreement. See the attached notice of cancellation form for an explanation of this right.
11. ENERGY BENEFITS.
The Sponsoring Utility Company(the Utility)is entitled to 100%of the energy benefits associated with all Energy Conservation Measures,excluding the
value of energy cost savings by the Customer,but including all rights to all associated ISO-NE Energy,Capacity and Reserves Products.NSL agrees to
provide the Utility with such further documentation as the Utility may request to confirm the Utility's ownership of such benefits and Products.
12. NOTICE CONCERNING SPONSORSHIP.
Customer understands and acknowledges that NSL is not an agent,vendor or sub-vendor of The Sponsoring Utility Company(the Utility)with respect to
the installation of an energy efficiency measures.In the event of the failure of an energy conservation device to perform as expected,Customer's sole
recourse is to Contractor and not to Conservation Services Group(CSG)or to the Utility.The Utility and its operating companies shall not maintain,
remove or perform any work whatsoever on the energy conservation measures installed.
Customer understands and acknowledges that their participation in the Mass Save Home Energy Services Program is voluntary and that they have
consented for Contractor to install the proposed energy conservation measures.
Customer agrees that it shall not hold CSG,the Utility,their affiliates or operating companies liable for Contractor's to perform its obligations under this
agreement,for failure of the energy conservation measures to function,for any damage to Customers Premises caused by Contractor or for any and all
damages to property or injury to persons caused by the energy conservation measures.
13. LIMITED TIME OFFER.
The prices and incentive offered in this Contract are subject to change in accordance with The Sponsoring Utility Company Mass Save Home Energy
Services Program offers.
14. CONTRACT CANCELLATION Under Massachusetts law,you may cancel this agreement if it has been signed by a party thereto at a
place other than an address of the seller,which may be his main office or a branch thereof,provided you notify the seller in writing
at his main office or branch by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business
day following the signing of this agreement.
Planview Diagram 11 4
Customer Vi s6yu Ducti Advisor Name: vI
Address 2.7 IiacN,Yhw vt Advisor Phone #:
Town N 41i Anjayr r D ! M5 Any limitations to access by truck?
Site ID
NOTES Any work scoped outside of Best Practices?
Approved by:
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ROGER A OVILLET
Wo umAck,RNI 023
RoWdebad Tv cSSwC-lnsulation Contractor
Failure to possess a currem edition Ofthe DW assachusetts
State Building C@Ie is cause for revoca'4on of this license.
For D,Ps Ucensing Worm-Oddo,
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,
O��ccIlf Consu�er� A fai and Business Regulation
10 Park Plaza e Suite 5170
Boston, Massachusetts 021116
Hoot Improvement Contractor Registration
Registration: 162111
Type: Supplement Card
Expiration: 1/14/2017
NEXT STEP LMNG INC.
ROGER OUELLETTE
21 DRYDOCK AVE. 2 U H FL
BOSTON, MA 02210
Update Address and return card.Mark reason for change.
Address E] Renewal E] Employment E] Lost Card
Office OF Consumer Affairs&Business IlBegu@skior, License or registration valid for individul nese only
DOME IMPROVEMENT CONTRACTORbeffore the expiration date. Rff found return too
office,of Consumer Affairs and Business Regulation
Registrold0n. 162111 Type: alb Parh Plaza-Suite 5170
Expiration: 1/14/2017 Suppiemc-ni cwd Boston,Pr/li A 0211
NE7(1 STEP)JANC)NG.
ROGER OUELLETTE
21 DRYDOCK AVE.2 T H FL —
BOSTON:MA 02210 0.i�adersecretsca, Pot valid without signature
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CERTIFICATE
I IG�LLIEI CANCEL
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sI IOUL.0 AN1,CTI a HR ADOV'DE-0,303F DI POMCAEG Dl;.n C A N(E,LE®BG6a)RN
For lnfor ra,.jLlow PnI!7 M! EXPIPATION DATE THEREw., NcroicE mi.('. ISI ®E["hvERED IN�
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94- r Office qf Investigations
' a ./ Congress Street, Suite.100
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Boston, MA 02114-2017
Workers'Compensation Insurance Affidavit: uflders/ 'onti-actors/ lectrici ns/ lumbers
Nae (Businiess/organizatiorn/Individtial) Nett Step Livia
Address: 21 Drydock Avg
--=
City/State/Zip o Boston, MA 02210 pholle e(866)867-8729
Are you an employer?Check the appropriate box- —--- Type of project(required): T
IA I am a employer with 350 4, E] I am a general contractor and I 6° New construction
_ employees(full arnd/or pail-tirrie)°4: have hired the sub-contractors
1U I am a sole proprietor or partner- listed on the attached sheet, 7° ®Remodeling
ship and have no employees 'hese sub-contractors have
8. Demolition
working for me in any capacity, employees and have workers'
[No workers' comp.insurance comp. insurance.-If �° �Building addition
required.) 5° We are a corporation and its 10° Electrical repairs or additions
0 I arra a homeowner doing all work officers have exercised their 11°®Itilutrnbin�repairs cr additions
myself, [No workers' comp. right of exemption per MGL 12,E]Roof repairs
insurance required.] t c. 152, §1(4),and we have me Insulation
employees. [No workers' 1 other
comp. insurance required.)
Anapplicant that:checks Y - - J
*Any pp box#1 must also fill out the section below showing their workers'compensation policy information,
`t homeowners vlhc,submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new afiidal it indicating such.
*Conti actors that check this boar rn-ast attached an additional sheet showing the name of the sub-contractors and state whether or spot Ilio se,ontitim leave
employees, ff the sub-contractors have employees,they must provide their workers'comp.policy number.
T arse an employer that,ns providing markers,Wrrapefisafion insurancefor,MY Mplay)ees. Bellow3,ns ibe policy a#r ,yoga aiir;,
informaeon.
Insurance Company Name: A.I°M Mutual Insurance Company
Policy#or Self-ins. Lic.#:AWC-400-703002 d2014A Expiration Date: 9/30/1
Job Site Address:_ 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 MGI,c. 152 can lead to the imposition of crirr al penalties of a
fine up to$1,500°00 and/or one-yeas imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fin
of up to$250°00 a day against the violator. Be advised%hat a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage v `fn tion.
Ido hereby cerrzi„y ander ghe palms an peaaal s g1my that the ififormadonprrovided above is trice and c®r recte
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Official use o alga Do not write in 9121s aiwek, to be eomplet"ed b e y or town.of�cxa�
t lty orTown.
Issuing Authority(circle one)-.
1.Board of Health 2,Building Department J. Cily,''I bff1..1 Urv°-r lK EIeeiiiq:Al.lnnspeel:on, 1 phimbiwAg Inspector
6mOther_
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