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HomeMy WebLinkAboutBuilding Permit # 3/4/2015 II BUILDING PERMITpF "°oT" qti TOWN OF NORTH ANDOVER F2 h�,,- . ...6F6 0 APPLICATION FOR PLAN EXAMINATION Permit No#: ,J° Date Received 7RADR,�7ED gSSACHus�t Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION � r r n PROPERTY OWNER ` � �rt y Pr z r Pnnt 1D0 1"', yes n MAP PARCEL ZONING DISTRIC, str"ict ' 'no, „. „> Mac me Shop Village yes „no' 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 ❑ Septic "❑UVell 01=(oodplairi Wetlands Watershed District q Wait s DESCRIPTION OF WORK TO BE PERFORMED: xh6r) Identification- Please Type or Print Clearly OWNER: Name: l�f(� C=L Phone: Address: Contractor Name: ore:; r Address , jai r S�pennsors Gons ructron License Exp Date K Home Irnpro�ement License ` /L� ��� , .; Exp ,,Date,,, <, 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: $_ 3(' d 6� Check No.: Receipt No.: NOTE: Persons contracting with acn ' t contractors do not have access to the f nd Signature of'Agent/Owner ignature of contractor N0RT1i -lu- ---- r own ol - 0 11 Uve . &46 T (, - it Y'ver, N.Sspp Atto6 T O� LANE . / l A_ COC NIC NE MACK � 7�A�R^TEOP S U BOARD OF HEALTH ER I Food/Kitchen Septic System THIS CERTIFIES THAT .....N.. . ► BUILDING INSPECTOR has permission to erect ............. buildings on ... Foundation ............ .... . .......... .. mmob.. ...- Rough tobe occupied as ........ "I. t� N.... ........ ....®.. ..� ... ......................................... Chimney provided that the person accepting this permits 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES 16 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI A T Rough Service ..........................................,..... ........... ............... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy RuRough 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 and-Approvethe Building Inspector. Burner Street No. Smoke Det. Fu.. r ➢M ee Of Consumer Affa ani Business Regulation 10 Pa�° Plaza e Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 162111 Type: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 DRYDOCK AVE. 2TH FL BOSTON, MAS 02210 Update Address and return card.Mark reason for change. Address D Renewal E] Employment E] host Card ':o a"d,.va'��Q office of Consumer Afffairs& Business Regulation License or registration valid foi-individul use only ���IMPROVEMENT CONTRACTOR the expiration date. if found return to: t ..f Office of Consumer Affairs and Business Regulation Regl5tratlon: 162911 Type: 10 Pare Plaza-Sujte'5170 Expiration: 1/14/2017 Supplement Card Boston,IYlfd 02116,, NEXT STEP LIVING INC. ROGER OUELLETTE " 21 DRYDOCK AVE.2TN FL — ��!� BOSTON;MIA 02210 Undersecretary ;�iWt alid without signature Massad4usefls [)epartrneM ot Pubhc Safety Bow'd of Bud Mng ReguWwws and Staiidards CSL-102811 ROGER A OVEL1497 55 STANMORE Wand&R-11 02M) 0911312016 Resivicted To: CSS OC-insulation Contractor Failure to possess a current edition of the Massachusetts Mate tate Building Code is cause for revoication of this license. For OPS Loco sing information visit' tAjwtpj.M@ss.GnvjDPS -- NEXTS-1 OP ID:EL _ DATE D=V---YCERTIFICATELIABILITY INSURANCE Ia/0112094 -=- - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 0%y AND CONFERS NO RIGHT4 UPCW TNV OPTIFIGATP HOLDER,THIS CERTWICA T E DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AI YHR THE a;OVERAAOE AFFORDED BY `ITIS POLIVIES 13E1.0%f. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHQRIZED ROR FSENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, _ IMPORTANT: If the pertificate holder is an ADDITIONAL INSURED,the policy(les)mast he endorsed. If SUBROGATION 14 WAIM-1 the terms and conditions of the policy,certain policies may require an endorsement. A statement an this certificate does not confer rights to 1hp certificate holder 111 lieu of such endorsement(s). PRODUCER CONTACT — Mt;LBu blip 1 su attep Agency NAME: Erin Lyons _ 9 I 0 y PHONE �I39-666.2776 FAx �01�566=02 Mel Lynn fel�s ParkWpy A/O No Ext: alc,No Meir®se,MA 02176 E-MAIL John E.McLaughlin Jr. ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL 9 INSURER A:Nautilus Insurance INSURED 21 D ydoStop IaAven Inc, INSURER 13:Commerce Insurance Company 3478 21 ®ryd®ck Avenu®,2nd Floor Busted,MA 62210 INSURER C:A.I.M.Mutual Insurance CO. INSURERD:AXIS Insurance Company 16610 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 PgRO INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICI` 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. 1 TR TYPE OF INSURANCE OL BD POLICY NUMBER Po M�9Y POLICYEXP LIMITS A X COMMERCIAL GENEUAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR ErP20101911=12 09/30/2014 09/30/2016 D AG TO RE TED 90®,®®® PREMISES Ea occurrence) $ MED EXP(Any one person) $ 1rvII®® PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S ,QI�®eWH POLICY❑JEST F1 LOC PRODUCTS-COMP/OPAGG OTHER: $ AUTOMOBILE LIABILITY CEa aOMBINED SINGLE LIMITccident $ s. s H ANY AUTO 14MMBOKKOM 09/3012014 09/30/2016 BODILY INJURY(Per person) S ALL AUTOS OWNED AUTOSSCHEDBODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR I V I OCCUR EACH OCCURRENCE S 5,000,00 D EXCESS LIAR CLAIMS-MADE El,U783647012014 09/30/2014 09/30/2016 AGGREGATE $ , Qa DED I I RETENTION$ $ WORKERS COMPENSATION -- —T� � PER OTH- u-" AND EMPLOYERS'LIABILITY STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN TO BE ISSUED BY CARRIER 09/3012014 04130/20'10 E.L.EACH ACCIDENT $ 600,000 OFFICERIMEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE.EA EMPLOYEE $ 500,00 if yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 600,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional P.emarks Schedule,may be attached if more space is required) FOR INFORNATION ONLY CERTIFICATE HOLDER CANCELLATION -- - -- INFO-011 -- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE F®r information Only THE EXPIRATION CRATE THEREOF, NOTICE WILL BE DELIVERED IN l ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE a ©19602014 ACORD CORPORATION. All rights reserved. ACORD 25(2014109) TI10 AOQRR 1i@M0 X01'®cq(liare rq.f AC®R . The Common wealth Department of Industrial Accidents Office of Investigations b I Congress Street, Su to 100 Boston, 41A 01142 017 WWW 3ttaXAVegoV1dH# Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information plaaea.print Name (Business/Organization/Indi3iid-aal): Next Step Living Address: 21 Drydock Ave City/State/Zip: Boston, MA 02210 phone#:(866)867-8729 Are you an employer? Check the appropriate box. Type of project(required): 1.V I am a employer with 850 4. E] I am a general contractor and 1 6. 0 New construction employees (full and/or part-time).* have hired the sub-contractors 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. E]Remodeling ship and have no employees These sub-contractors have 8. [J Demolition working for me in any capacity. employees and have workers' 9. ®Building addition [No workers' comp. insurance comp. insuranceJ required.] 5. E] We are a corporation and its I0.EJ Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.E]Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.§Other Insulatlon comp. insurance required.] _J *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 him outside contractors must submit a new affidalit indicating such. tConftactors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entitim 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: A.I.M Mutual Insurance Company Policy#or Self-ins. Lie.#.AWC400-7030025-2014A Expiration Date: 9/30115 Job Site Address: City/State/Zip: -_— -_ I 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 advise i d that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage 79190tion. I do hereby certify under the pains perjury that the information provided above is true and correct Sig!1ature: _!t t Date: Phone#Mtoto)&:7-9-7aq 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 0. next step Liv B i TIVi Estimate pending resolution of Health or Safety Issues Next Step Living,Inc.("NSL") Kara Feraco 21 Drydock Avenue,2nd floor Boston,MA 02210 42 Church St#1 phone: (866)867-8729 North Andover, MA 01845 Site ID: A549717 27-Aug-14 1. DESCRIPTION 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 order describing the work in detail(the"Work")which are incorporated herein by reference: -Investment.- Description Quantity Work Location: Attic Flat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 2 Hr $150.00 Work Location: Wall Insulate Vinyl Sided Wall With 4"Dense Pack Cellulose 1,560 scift $2,574.00 Work Location: Foundation Insulate Rim Joist with 6.25"Fiberglass Batting 154 Lnft $269.50 Initial Investment: $2,993.50 MA Save CMA Weatherization Incentive $2,150.00 Total Net Investment: $843.50 Estimated Annual Energy Savings from the Above Improvements $400.00 2. PAYMENT: 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 113 of the total retail costs. (Note:Mastercard,Visa,and Discover accepted) Additional Payments and Final Invoice: $743.50 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. 27 Aug 2014 Andrew Carpentier NSL Signature Date Name of NSL Representative The Terms of this Agreement are contained on both sides of this page Next Step Living^21 Drydock Avenue o 2nd floor-Boston,MA 02210.(866)867-8729.inquiry@nextsteplivinginc.com o www nextstepliving_com TERMS OF AGREEMENT A549717 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,ourweatherization 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 haft work unfit 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 Customers 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 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. 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 RISE Engineering(RISE) 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 RISE,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 telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. Planview Diagram Customer a.r-4 r Advisor Name: Al 7Y' Address tiZ h orc,� Si. 4J-1- Advisor Phone #: a S"S3vs Town Aj v-.-4-ti t— Any limitations to access by truck? Site ID q -71 `? Al-0 NOTES Any work scoped outside of Best Practices? Approved by: 2tir3 A-/s - YZJ O I,fc� llS � r, p��— i560 — ✓,, G -94-`i %to 3 d � 3 v sr3 z L S 3 � " 3 i z � 3 Z