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Home My WebLink AboutBuilding Permit # 3/2/2015 . .... .................. . .................. .......................................... .. .............................. ---------------- ............................................................................................................................................................................. --------------------------- t%ORTH BUILDING PERMIT' TOWN OF NORTH ANDOVER,: —Aw C> APPLICATION FOR PLAN EXAMINATIQN. Permit No#: Date,Received, �SSAC Date Issued: TANT: Applicant must complete.. all.--items�on.Ahis page IMPOR II TYPE OF IMPROVEMENT— PROPOSED USE Residential Non- Residential El New Building 0 One family 0 Industrial [I Addition Li Two or more family 11 Alteration No. of units: O'Commercial 0 Repair, replacement El Assessory Bldg El Others: El Demolition 0 Other hil t 11"N1,11111111MId-1111" .DESTIPTION OF WOFK-.,T ERFORIVIED: I!q ft'k _Identification- Please Type or Print Clearly OWNER: Name: 2)0 Phone: Address: U C41, tl o q. ARCHITECT/ENGINEER Phond; Address: FEE SCHEDULE.BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED:COST BASED ON$125.00 PER S-F=— Total Project Cost: $ 1, 66 Check No.: Recqipt,:,N&`. NOTE: Persons contractink with unregistered contracto'rs,*,,do,.not:have,�access to the g ty f W d _ 1707�7, !9P, P N NORTfi own of2 ? -mover Oaft '.ft n 6kr 6 ® 4 Ty �— ti h ver, N tA(E S 9 a aaNS C OCHICHl WICK 1' SAO P�� 7�S RATED V BOARD OF HEALTH Food/Kitchen S PER�� MlTj�� Septic System THIS CERTIFIES THAT BUILDING INSPECTOR ...................................... .................................................................................... �a� �. Foundation has permission to erect .......................... buildingson ... .............. ........ ................... • ..•.... Rough . . to be occupied as ...... ... . ..... . .. . ... 111�. .1�! O` .................................................. chimney provided that the person accepting this permit sRall in every respect conform to the terms of thea application 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 CONSTRUCT ARTS Rough Service ................................................................................ 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. V4 Federal ib 0 RISE Engineering Rl contractor Registration No MA Contractor Registration No A division ofThiclsch Engineering CT Contractor Registration No 60 Shawmut Unit#2,Canton,MA 02021 , TRACT 339-502.6335 FAX 339-502«6345 R Ipage i S E PROGRAM THIS COMMeT is vmrm INTO aETWEEN rtk9E ENCINEERING CMA-HES SD �nrBELOu aEaaaaraaaEnFnnwnnxAa cammm Y, _...,....._._.. _.PHONE ._._�.�_.., DATE ��..._GtiENra WORK Osumi Jennifer Vautour (860)402-0865 12/31/2014 44461 M-~ aEnvICE STnEE.T MANG OMF" _..._- _,__ ...._ ✓"� �:_'�b �� t 201 Andover Street 201 Andover Street SE.MnCE ci7Y,STATE,X10 BUNG CRY,STATE,ZIP 4" North Andover,MA 01845 North Andover,MA 01 JOB DESCRIPTION PHASE ONE-Proposal for this calendar year. $0.00 AIR SEALING,Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This wort:will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange Brad indoor air quality,Materials to be used to seal your home can include caulks,fbants,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements,attached garoges and other unheated areas(windows are not generally addressed.) (8)working hours. At the completion of the weatherization work,and at no additional cost to the homeowner,a final blower door and/or combustion safety analysis will be conducted by the subcontractor to ensure the safety of the indoor air quality. $600.00 ATTIC FLAT:Provide labor and materials to instuil o 4"layer of R44 Class I Cellulose added to(16)square feet ofiloomd attic space. $27.44 DAMMiNG:Provide labor and materials to install a 12"layer of R 38 unlaced fiberglass baits to(16)square Feet for damming purposes. $32.80 ATTIC FLAT.Provide labor and materials to install a 12"layer of R-42 Class I Cellulose added to(614)square feet ofopen attic apace. $933.28 SLOPES:Provide labor and materials to install a 6"layer of'R-21 Class 1 Cellulose added to(185)square feet of slope area. Wherever possible baffles will be installed to the entire length ofeach bay to maintain ventilation space, $344.10 ATTIC ACCESS:Provide labor and materials to insulate the back of(1)aftichatch with 2"rigid Thenttae board.Weatherstrip the perimeter. $60.00 VENTILATION:Provide labor and materials to install(4)12"X t8"aluminum gable end attic vent. $494A0 VENT LAT1ON:Provide labor and materials to install ventilation chutes in(40)rafter boys to maintain air flow, $80,00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will only be billed the Net amount. Currently, for eligible measures,Columbia Gas offers 75%incentive,not to exceed$2,000 per calendar year,and an incentive or t 0o%for the Air Scaling measures up to$600. For the safety and health ofyour home's indoor air quality,we will be conducting a blower door diagnostic of the available air flow in your home both before die work is begun,and after the weatherization work is complete.We will also conduct a full assessment of the combustion safety of your heating sysicm grid water heater.This has a value of$90 and is at no cost to you. `rotas allowable weatherization incentive is$2,690. $90.00 Federal i0 9 RISE Engineering RI Contractor Registration No MA Contractor Registration No A division of Thictach Engineering CT Contractor Registration No � 60 Shnwmut Unit 112 Canton,MA 02021 CONTRACT 339-502-6325 FAX 339-502-6345 Page 2 PROGRAM THIS CONTRACT IS ENTERER INTO SEMEEN RISE CMA-PIES SNOINEERUJO AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMERI`HONEOATE CLIENT N WQNKORDER _ Jennifer Vautour (860)402-0865 12/31/2014 404610 00004 SERVICE STREET UILLINO 201 Andover Street 201 Andover Street SETNICE CITY,STATE,21P UILLING CITY,BTATE,ZP ....�— ....__....—� �_ North Andover,MA 01845 North Andover,MA 01845 JOB DESCRIPTION Total: $2,661.22 Program Incentive: $2,168.41 Customer Total: $482.81 WE AGREE HERESY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF 'Four Hundred Ninety-Two&811100[dollars $492.81 UPON FURL INSPECTION AND APPROVAL BY R159" NJMRING.CUSTOMER AGRM TO REMIT AMOUNTOUS IN FULL itrMMIE OF I w WILL HE CRUURDE:D MONTHLY ON ANY UNPAJD BALANCE AFTER aO DAYS.SEC FVMeF MPORTANT INFQRMATION ON GUARANTEES,RIGHTS OF REVISION,SVIIEDULINO,ANO CONTRACTOR REoismnom. '.. Map NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK CE A 0 0SIGNA RE- EEngln ng ��. ..��.� CBS- ER ACC CE NOTE:THIS CONTRACT MAY DE WTMDRAWN BY US tF NOT EXECUTED WITHIN DATE OF ACCEPTANCE ACCEPTANCE OF CONTRACT-THE ADOVE PRICES,S ECIFTCATONS AND CONDMONS ARE 30RAYS. SATISFACTORY TO US AND ARE HERESY ACCEPTED.YOU AREAUTIORIZEDTO DOTHE WORK AS SPECIFIED.PAYMENT WILT.UE MADE AS OUTLINES ABOVE J ,ao° i i OWNER AUTHORIZATION FORM Jennifer Vautour I, (Owner's Name) owner of the property located at 201 Andover Street, North Andover, MA 01845 (Property Address) 201 Andover Street, North Andover, MA 01845 (Property Address) hereby authorize , (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. wne s Signature Date �o�a��r��taa:cuerrlf�Q��aaatcc/%usef� Office of Consumer Affairs&SusinessRegutatioa License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: eg ration: 104800 Type: Office of Consumer Affairs and Business Regulation xpiration:: 715201& Private Corporation 10 Park Plaza-Suite 517.0 HUGH'S ENERGY COR;PORATjON`:' Boston,MA 02I16 DANIEL DRISCOLL 259 MILTON STREET DEDHAM,MA 02026 Undersecretary Not valid without signatu �gS�achusetfs-t?epartme �f E::iivir} aeys;iaff of public Safety ion DC7!}ii}ti l'Clflli Jiljl6°!ti LS[Il ,�a:tCi vfa3 i"arz^s License:C"50784 T11o1nas `��i•ri:ti PDttsmgo9re .. •.. � 259IWIton Street a D _ ed!'am Mq 0206 5 = rs CornMissioner 4Xpirafion 90/2.x/2096 0 c TDINi1-1 OP ID:MR CER71F1AT F LIABILITY INSURANCE �AT� rn �THI$CI<FtT9FlCATE t$ISSUED ASA MATTER OF INFORd(ATION ONLY AND CONFERS 701001201, CERTIFICATE DOES NOT AFF1(21yATlVELY OR NEGATIVELY AMEND Nb RIGHTS UPON THE CERTIFICATE HOLDER,THiS BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CO ' EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES' REPRESENTATWE OR PRODUCER,AND THE CERTIFICATE HOLDER. TE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED IMPORTANT: ff the certificaba holder is an ADDITIONAL INSURED,the pcil the terms and conditions of the policy,certain policies mom)must be endorsed, if SUBROGATION 15 WANED,subject to cDUCEcate holder in!t¢u of such endarsetne s, �require an endorsement, A statement on this certificate does not confer rights to the PRODUCER TYG insuranc�e gqg�ency,Inc. co !►� 68 Freeman Sfiase� Adln&R,MA 02474.8614 s 787.8$9•.$002 Ax - eaKAtl. c Ne 789-8493009 REBS: INSURER( APFDRt)INGCaYERAW NAIc# INSURED TO Insulation, nc. wsuRERA:ScMdateinsurance Com an 259 Milton Street MURHi13:AmGuard insurance Com ny Dedham,MA 02026 May a iArbalft PratecttaR Ins II INsuRetc, 41360 --------------------- INSURER E: COVERAGES CERTIFICATE NUMBER; tNsuRER F: THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE gE ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD REVISION NUMBER: INDICATED. NDTWfTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CO CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDEp BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, NTRACT OR OTHER DOCUMENT WiTH RESPECT TO WHICH THIS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,UMI SHOWN MAY HAVE SEEN REDUCED 8Y PAID CLAIMS. �iR 7YP80FINSORANCE A X COMirtmcluGENERAI.uAmmy POLicYNUMaEt ev arms cLruMSMAOE MGM X X CPS2020992 EWHOCCURRENC6 S 9,000,00 08/14J20i4 08/i�ltZ0i5 p S 50,00 ME0W Oneperson S 5100 GEMAGGREQA7ELMffAPPUESPIIt PERSONAL&ADYKIURY 5 9,000,00 PoUCY J ❑Loc G>DIERALAGQREGATE S 2,000,00 ML, PRODUCTS-(,O}IpipPAGO S 2,000,00 AUiOMOSME UMMny C ANYAuro s s A�UrOas� X SCHEDULED 1020032Y64 08/1412014 081142015 eDDILY INJURY S 9,000100 AWQ3 (Perp==) g HtRfiDAUTti3 pUTOSNDWNED eODILYINJURY{Peraeddanq g UMBRELLA LU1" X OCCUR g 1 MD A EXCE8SL1CLA1MSI E BS0044410 EACHOCC(lRRENCE S 1,000,0 DED X REmunDNS 90000 90/07/2044 08/1412a15 qm wORlO;RgODy{pgRSATION s 1,000,00 AND EMPLOYl3�LIABlU7y $ AOFMNYPROPRIEiOR1pARTNERIpCECUTNE Y►N R2WC513M xnJrE E2 (III InNH)EmauDma NN NIA 08/12/2014 08112/2015 1►ras,desalbeunder EL.EAWACCIOENTc nib" S 500100 ommerMcf DPoPERAnDNsn�cw EL DISEASE.EAEMPLoY S 500,00 CommerctalAppltC2 ELDisEABE-PDLiCYUMIT s 500,00 DESCRIFnONOFOPERAI7ONS/LOCA7iONSlVEH[CLE5(ACDROIat.AddfH0 nelR¢matksSe11a6uto,mayboattsehaCifmoraspatetemq, nl CERTIFICATE HOLDER CANCELLATiON ADRRCHE SHOULD ANYOFTHEABOVE DESCRIBED POLICIES CANCELLED B THE EXPIRATION DATE THEREOF NOTICE BEFORE WILL BE CANCELLLEDBEF QI ACCORDANCE MM THE:POLICY pItOViSION$ AUitlDRQJ;D REPRESEITA7NE ACORD 25(2094101) The ACORD name and logo are registered marks 1988-2014 OFACORt) CORPORATION. All rights reserved. The Commonwealth of Massachusetts Department oflndustrialAccidents - 1 Congress Street,Suite 100 Boston,MA 02114-2017 sV`v`�t www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): !� (� Address: jGGU �/1 City/State/Zip: Phone#: 7y-/ 666 �3 86 Are you an employer?Check the appropriate box: 'Type of project(required): _-!,Q- a a employer with employees(full and/or part-time).* 7. El New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.] 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 1 El Demolition 10 E]Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 5.F]I am a general co• 12.0 Plumbing repairs or additions ntractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.Q We are a corporation and its officers have exercised their right of'exemption per MGL c. 14. they 152,§1(4),and we have no employees.[No workers'comp.insurance required.] 2 ` *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i 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 insurance for my employees. Below is the policy and job site information. Insurance Company Name: -�}'� ��, v rt-y'l� Policy#or Self-ins.Lic. Expiration Date: /S 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 MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DTA.for insurance coverage verification. Ido hereby cert1j'y under tlr aius ndp naltie perjury that the information provided above is tare and correct. Signature: �'i Date: _�- _ )-J ( Phone#: 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#: