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HomeMy WebLinkAboutBuilding Permit # 3/2/2015 r: BUILDING PERMIT NORTH 0��.{LED 16�•v0 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION _ Permit No#: W. Date Received �,°"�RArED �SSACHUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page r rrr rr , /irrr� ����r���/ r / r r rr ,, r ✓ � / l / /r r r/ .....MAP � TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial f ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other r ,,.r r, ,?,, r�❑ at / ' L r/ ❑-:Flood Iain ❑Wetlands UV ershed District r❑ Se tam,, ❑ // /// // r,r r p r r - / .../ ✓i// „r r<,,...,/r.. r r /.,/ „/.. I i ,.:,,,, ,.., ,,,,,../ rrr.. . r rr ..,. ri:// , ri .✓/i„ r //i/ / r // r / .,,/ / i /„ r:r,i /,,,r ., r, rrr c 1 r/� /i r / .✓.,,.o iii,/ � r r ..,.,,,. / / r, r/ r ,..<...r, r r/ ✓.. /.,i/// . rrrr a,r c,. r ...,. ri,r /r %. , r..../I/ / / .,i/ /.r, /. / /.,,..// r//,' r, .,i, 1, ,,,,o,,, / ,... r ./// ,/., /< ✓/, DESCRIPTION OF WORK TO BE PERFORMED: Air h Identification- Please Type or Print Clearly OWNER: Name: Phone: Address:a5 a ddOI/ 1rl'' r, ,r„'r ri/. rr/f / ,,,, „✓, ,,,. ,, ,,,.. r /,..,r ,///i ,i//r /,/ rrr/ ri ,,,> ,✓i, ,.»,,,r _i, ,i� ,, r,l r.:,✓>iir,r ,.., „..r/, .� // ✓.,:: /r/,i>.. //✓/r /r„ ,,,. . r,,.- ,./ o/�%/%- ,r,/,,/r„/ rim, r,r, r rr -r ., / ,.. ,,. r....,rr r / ...,rr r ./ /r...,.✓r, .moi , / r,. / /r / / J r, r r a r /" r / r / ✓/ r rr r r r r r r / i / p rr ri � rr r ,r •, r rr rr / r/ //r /, r r rr // ./ ✓i/ rr.. �, 1, ,, „ri� /,// //✓r /� /, / % , � r � ��„ 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 ur is a contractors do not have access to th u a ty 1, Signature of Agent/Owner Signature of contractor F NORTFj Town of ndover No. GTi, LA-"I ��oth ver, Mass, COCNICMEW.CK y1. x,95 RATED 1,10:1 (5 U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System Ak THIS CERTIFIES THAT ....... .. .. .. . ... ...... . ...................................................... THIS INSPECTOR has permission to erect .......................... buildings on Foundation Rough to be occupied as ........ !: '.. :. riin .. ..... */. ............. Chimney provided that the person accepting this permit 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 30' UNLESS CONSTRUCTIO A Rough Service ..................... ...... .. ............ Final BUILDING INSPECTOR GAS INSPECTOR OccupancE Permit Required to Occupy Ruildin 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 In ector. Burner Street No. Smoke Det. This agreement is made by and among Next Step Living, Inc.("NSL") Larry Johansen 21 Dryclock Avenue,2nd floor 338 Salem St Boston, MA 02210 phone: (866)867-8729 North Andover, MA 01845 Site ID 406327 06-Feb-15 1. DESCRIPTION OF WORK TO BE PERFORMED N 3L viill perforn 3 or arse to 0C.'performed the following work on the cuslo'ner"address ai jovl' 1 a professional manner and in accordance ,vilh the terms of this Contract,including(tie attached te(,oiiinieti(iatioiis/,,,ioil<order describing thR,,vofk in detail(the which are incorporated herein by reference: ' F I 90_0� Work. Location Attic Flat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 12 $75.00 Hr $900.00 Work Location Attic Flat Whole house fan box: Thermal Barrier P lyiso 2" (Attic) 1 $209.21 Each $209.21 Hatch: Thermal Barrier Polyiso 2 inch (Attic) 1 $60.00 Each $60.00 Vent bath fan to soffit exhaust 1 $118.75 Each $118.75 ......... . ...... 100%Airsealing Incentive up to Program Max $600.00 75 %Weatherization Incentive up to Program Max $290.97 Air Sealing Remainder as 75 %Weatherization Incentive up to Program Max $225.00 .......... Estimated Annual Energy Savings from the Above Improvements $121.00 2. 1AYMENT: CUSTOMER agrees to pay NSL for the work as follows: Payment#1: $100.00 -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 exceed 1/3 of the total retail costs. (Note:Mastercard,Visa,and Discover accepted) Additional Payments and Final Invoice: $71.99 -Additional Davments 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. Feb 23, 2015 Customer Signature Date Feb 9, 2015 Courtney Hally 6 Feb 2015 Andrew Carpentier NSL Signature Date Name of NSL Representative A640417 The Terms of this Agreement are contained on both sides of this page Next Step Living 21 Drydock Avenue-2nd floor-Boston,MA 02210�(866)867-8729-inquiry@nextsteplivinginc.com�Www.nextstepriving.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 bywriting to Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170,Boston,MA 02116.617.973.8700. 5. PERMITS NSL will be responsible for obtaining 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 fumished 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 one 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 Customers 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 properly 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. 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. 12.1 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. 12.2 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. 12.3 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 Customer's 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 fax,or by e-mail sent or by delivery,not later than midnight of the third business day following the signing of this agreement. Plainview Diagram Customer Lara, J o ka sen Advisor Name: Address Sa fey., 5+ Advisor Phone #: Town SIU, A-Lo&— Any limitations to access by truck? Site ID LL 0632`1 1k) NOTES Any work scoped outside of Best Practices? Approved by: — 3 � �4F — - uen+ 13 F s 6 + j 3�tS W40 O 26 � L46 Lo fM "W'�P ' m'." I�"W+Q ' r ��/ei_ 4'�"v�.ar�dh G"'l G✓l d ;fl�'V',^'�,%P X+ °4�M,AI/i' � ice �o' �� ��° ffi an Business Regulation "Y' 10 Park Plaza - Suite 5170 Bostong Massachusetts 02116 Home Improvement Co tractor Registration Registration: 162111 Typo: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 DRYDOCK AVE. 2TH PL BOSTON, MA 0221 (Update Address and return card.mark reason for change. Address E] Renewal 0 Employment E] Lost Card d9tC¢e of Consuvn¢v AffairsBusinessRegulationLicense or registration valid for individul use only before the expiration date. If found return to: Al HOME IMPROVEMENT CONTRACTORoff{ece of ConsumerAfSgirS avid Business Regulation Registration: 162111 Type: 10 Park Plaza-Suite 5170 Expiration' 1J1412017 Suppiement Card Boston,MA 02116. NEXT STEP LIVING INC. ROGER OUELLETTE 21 DRYDOCK AVE.2TH FL Not — valid�vithoaet Signature BOSTON,MA 02210 Undersecretary ' ro. W 0 Jd ria 6,:1�A ROGS R A(OVE, FI mm ,form, Resivictsd TO'. CSSL-OC einsul`:Ition Contr@C'bor Fai I u re to pw,Sass a cu rrem edition Cl the Mi assachuselts saes Bui Id i ng Code is Ofus-a f(o)r revoca i(Dn or this licensee For®PS Liconsing infmmatdon vidt' The Commonwealth of Massachusetts Department of IndustrialAccidents Ogee of Invesdgations a d 11 Congress Street, Suite 100 f Boston,MA 02114-2017 c, V waves ass.gov/dia Workers' Compensation Insurance Affidavit-. Builders/Contractors/Electricians/Plumbers AppUcant Information Please Print legibly Name (Business/Organizationdlndividual) Next Step Living Address: 21 Drydock Ave city/State/Zip: Boston, MA 02210 Phone#a(866)067-6729 Are you an employer?Check the appropriate box: 'Type of project(required): I.@ I am a employer with II60 4. ® I am a general contractor and 1 6. New construction employees (full and/or part-time).* have hired the subcontractors 2.® I am a sole proprietor or partner- listed on the attached sheet. 7. ®Remodeling ship and have no employees These subcontractors have B. ®Demolition and have workers'working for me in any capacity. employees9. ®wilding addition [No workers' comp.insurance comp.insurance.! 5. 0 We are a corporation and its 10.[)Electrical repairs or additions required.] 3. I am a homeowner doing all work officers have exercised their I l,®Plumbing repairs or additions ® myself. [No workers comp. right of exemption per MGL, 12,®hoof repairs insurance required.] t c. 152, §1(4),and we have no 13.®other Insulation employees. [No workers' comp. insurance required.] *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 aflidarit indicating such. $contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or i1ot those ontities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I arra an employer that is providing workers'c®anPefistadOn irssur°afic0 f r my employees° Below is the policy and job site anf®rraaadora° Insurance Company Name: A.I.M Mutual Insurance Company Policy#or Self-ins. I,ic.#: AWC-400-7030026-2014A Expiration Date: 9/30/16 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 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of investigations of the IIIA for insurance coverage vo-6 tion. I do hereby eer y'seder the palms andpenoldes perjury that the informadoec provided above is true and correct Si azure: Date: a D Phone# FEOther use oral,. Do root aerate era this area,to be completed by Baty or town official. or Town: Perenit/1,lcense.# thority(circle one). , health 2°Building(Department 3°City/Town Clerk 4°Electrical Inspector 5°Plumbing Inspector rs®an° Phone#o NEXTSo1 OIC ID:EL DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 1010V2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 0%y AND CONFER$ NO RIGIJTq UPDN TNV Cs RTIVIGT� HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ASTER THE COVERAGE AFFORDED BY THE POLICIES ��y l THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT DEPBEEN THE ISSUING INSURER(S), APTHOR140 RSP �SENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ISP RjANT: It the�ertiPcate hrslder i�1n A®®ITIONAL INSURED,the p®li�y(ies)BTI@9St lae el9d®eyed. It SI9HR®DATION I�K9�I���:OB����� ttae teM�geld c®nd'atlaa�e o�tlae TIc lioy,ceet�irl(c�liclev an��regLaire ae�encloe�eruaen't, A otetetraent On IIji5�ettiticete�loe�nct c®ntet eicUitt�to lhp o@�tificate 7a®Idea in lielt®g�tich enolor�enaent(�)• coNTACT — FRODUCER NAME: Erlr'e Lyt�lt� AIc No E:d 82I3 Lynn feI PaeicWpy EMAIL Melrose,SIA 02976 ADDRESS: John E.AifICLaughlin Jr. INSURER(S)AFFORDING COVERAGE NAIL 0 INSURER A;Nautilus Insurance INSURSD �xt�t�� LIViea ,Inc. INSURER :Commerce Isasasrance ®riapally ���a, 29 Drydock Avenue,2nd Floor INsuReRc:A=IX Mutual Insuraeace Co. Boston,MA 02290 INSURER DAMS Insurance Company ����® 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 NAMED ABOVE FOR THE POLICY P�RIBP INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T I9 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, DOL UBR FOL CY EFF POLICY EXP LIMITS I S "TYPE OF INSURANCE D D FOLICY NUMBER: MMIDD= (MMIDD 9,000,000 COMMERCIAL GEtyk�AL LIABILITY EACH OCCURRENCE $ DA AG TO RE TED CLAIMS-MADE OCCUR E,P�09999�=9� 09/30/20941 09/30/2095 PREMISES Ea occurrence $ �Q®'®®0 MED EXP(Anyone person) $ 0,TQt00 PERSONAL&ADV INJURY $ t s fl GENERAL AGGREGATE S 4�eOff®,I�Q GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ElPRO- LOC PRODUCTS-COMP/OP AGG $JECT OTHER: COMBINED SINGLE LIMIT $ 9aR09,®R® AUTOMOBILE LIABILITY Ea accident 9g�I�1I CGgP�DM 09/30/209,1 0100/2090 BODILY INJURY(Per person) S ANY AUTO ALL OWNEDSCHEDULED BODILYINJURY(Peraccident) $ AUTOS X AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident HIRED AUTOS AUTOS S UMBRELLA LIAR OCCUR EACH OCCURRENCE ® EICCESSLIAR CLAIMS MADE EI?U@O�e4�®@093 00/3012094 09/30/2095 AGGREGATE S DED RETENTIONS PER ERH WORKERS COMPENSATION AND EMPLOYERS'LIABILITY `d'�EE IITSUED�Y CARRIER 09/30/ 094 6(?f/3®1090 E.L.EACH ACCIDENT S 500,000 ANY PROPRIMS R/PARTNDR/ESCECUTIVE Y!�N I A 600 00 OFFICERIMEMSER F]CCLUDED? E.L.DISEASE•EA EMPLOYEE $ , (Mandatory In NN) 500 000 Uesdescribe under E.L.DISEASE-POLICY LIMIT' S , RIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 109,Additional Remarks Schedule,may fie attacbad if more space is raguired) CERTIFICATE MOLDER CANCELLATION 8MFO-09 SHOULD ANY OF THE l-4L3+049E DESCRIBE®POLICIES BE CANCELLED BEFORE THE EltPIRATION [SATE THEREOF, NOTICE WILL BE DELIVERED IN For Informollon Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©9988-2094 ACORD CORPORATION. All eights reserved. A(;®R®25(2®9419) TNS�6���� �� 4�� ar ®q����r A�®R