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HomeMy WebLinkAboutBuilding Permit # 4/13/2015 BUILDING 1 6dIL ' PE MIT Oft%O RTF{ ,.CUED TOWN F NRTH �� y ,;,. =6 00� APPLICATION FOR PLAN EXAMINATION ArPermit No#: , Date Received `°°"'°"-11 � CRATED Date Issued: US IMPORTANT:Applicant must complete all items on this page r ,,; ,,.,�i ri�� ,.. r / ✓r r „ ,ry rir r rri i,r. ;,,. r i"� ,:: /i..:� ,,, r / ,,, /% �/" P.nnt // rim ry / i 100 Year Structure �,,!r, es r,, „�„no /i /%% /r ri r / MAP/„ �r r i//PARCEL/ ZONING`DIST CT c D s �! t es a RI Hrst nct; illage yes Mac me Sho �� o p 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 q Well; ❑ Floodplain 1/Veflands ❑ Waters 'e District Water/Sewer r r DESCRIPTION,OF WORK TO BE PERFORMED: ;/o n Id ntification- Please Type or Print Clearly OWNER: Name_ y 1 Phone: Address: l�1 j(2-- MR , Confiractor Name Phone r r, r - rHome Irnpravement License ' , 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: $ on T FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with g' d contractors do not have access to the a rad Signature of Agent/Owner Signature of contractor H nd., V V1 0 IFVIV , -7 T 2 - ri 24 (45 T O LAKE h ver, Mass Aap—*l COCHICKFWICK ADRATED'�P�,`�� ; S U BOARD OF HEALTH I Food/Kitchen Septic System THIS CERTIFIES THAT ........ BUILDING INSPECTOR j� ft Foundation has permission to erect .......................... buildings on ......41r..... !!!'.'... ......................... Rough . .. to be occupied as .... . ...... .... ...... �. ..� ........................................ ... Chimney provided that the person accepting this permit sh14' 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 I 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRUCTION T TS Rough / Service .................... ...................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy BuRough 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. .: next step living, home energy solutions This agreement is made by and among Next Step Living,Inc.("NSL") Saket Sankhla 21 Drydock Avenue,2nd floor 8 Bucklin Rd Boston,MA 02210 North Andover, MA 01845 phone: (866)867-8729 Site ID: 410132 19-Dec-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: DescriptionQuantity Air Sealing Recommendations Work Location: Attic Flat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 4 $75.00 Hr $300.00 Work Location: Doors Door Weatherstripping w/Sweep 2 $75.00 Each $150.00 Weatherization Recomme ndat• Work Location: Attic Flat Attic Stair Cover Thermal Barrier with Carpentry 1 $237.65 Each $237.65 Damming 88 $2.05 Lnft $180.40 Vent bath fan to soffit exhaust 2 $118.75 Each $237.50 Propavent 2'or 4' 52 $2.00 Each $104.00 Attic Floor Open Blow Cellulose 9" 152 $1.36 sqft $206.72 Attic Floor Enclosed Cellulose Dense Pack 6" 836 $1.78 sqft $1,488.08 Initial Investment: .0, .35 100%Airsealing Incentive up to Program Max $450.00 75%Weatherization incentive up to Program Max $1,840.76 Total Net Investment: $613.59 Estimated Annual Energy Savings from the Above Improvements $469.00 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 1/3 of the total retail costs. (Note:Mastercard,Visa,and Discover accepted) Additional Payments and Final Invoice: $513.59 -Additional Payments for the Work shall be due upon completion of the Work. 'Dec,19 20t4 Custom Signatu a Date 19 Dec 2014 Willi Aquino N81-Sign ure Date Name of NSL Representative A717269 The Terms of this Agreement are contained on both sides of this page Next Step Living 21 Drydock Avenue"2nd floor"Boston,MA 02210 o(866)867-8729"Inquiry@nextsteplivinginc.com o 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 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 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 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. Mass Save Planview Diagram if Customer So-e-+ San i h(o, Advisor Name: Address % C(,in IZ.D Advisor Number: I "gal- Town N I ISMS Any limitations to access by truck? Site ID q 1015A NOTIS 4 hrS 'L ✓ ' -q' G) T0 S . �YPGYIfi� 1 ✓ s �.Oo YYUI... ✓/ err iv SoFf+t -c 4iau,ot 2 ®Pro pa.vtv�� Z:u r 4 SZ ✓ 0010pIbe, in AA-?+c 152.8 DPC in ASK t V1-DO rL SS3lA� v� V►a d a Ate-� -V„vj9 2 (DO 3 PoS S ® 22 Z ©O y 1 ConsumerOffice of Affairs and Busflrr���� Regulation 10 Park Plaza = Seita 5170 Boston, Massachusetts 0211 Home Improvement Contractor Registration :ergistration: 162111 Type: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLE T TE 21 DRYDOCK AVE. 2TH FL BOSTON, MA 02210 (Update Address arnd return card.Ia/i[ark reason for change. Address [:] Renewal E] Ean ploynnaent F] LostCard (office Business Regulation License or registration valid for inndividaai use only HOME IMPROVM��9T C06�T6�ACTOR before the e%pirationn date, Te found return to: office of Consumer Affairs and Business Regulation Registration: 162111 Type: 1011park Plaza..Smite 517D Expiration: 111412017 Supplerneni4 Cavd Bosto n,Mi A 02116 NEXT STEP LMNG)MG. R(DGER OUELLETTE 21 DPYDOCK AVE.2TH FL 5'� — BOSTON.MA 02210 �ieaders��retauy Not valid without signature ....... ROGS R A UYELLINT I 55 S` AI ONS") Rezidded To, CSSWC-ffisuktion Contractor Failure to possess a curreve edition G�the RibisSachusel I-t s State Widing Cde is cause for revocation CO this HUPOSO. 10k, Depuriffielip-olf-ladymirialAccidenis 'rhx Iavesfigadofl-�' 70 mgres"?A ap" cfO+ ftestorl" Atl e A, Workers' Compensation bstirance Affidavit-. ant Informawn Please 'print Legibi Next Step LMI-ig Address: 21 Dydock Ave C i Boston, MA 02210 ty/State/Zipp: (866)B67-8729 Are you an employer?Check the appropriate box-, Type of project(required): I I am a employer with 850 4. r] I am a general contractor and 1 6. [J-New construction employees (fhli and/or part-ime),* e,mired the sub-contractors 1 El I am a sole proprietor or partner- listed on the attached sheet, 7. Remodeling ship and have no employees These sub-contractors have 9. Demolition working for me in any capacity, employees and have=workers' 9, E]Building addition [No workers' comp,insurance comp. insurance.1 required] 5. 0 We are a corporation and its 10.n Electrical repairs or additions 3.F_1_ I am 9,homeowner do-Ing all work officers have exercised their I LEI Plumbing repairs or additions myself [No workers' comp. d&of ememption per MG1 12.0 Roof repairs insurance-required.] t c. 152, g1(4),and we have no employees. []oto workers' 13JM_ Other comp. insurance required.] *An-y applicant the.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 affidal it indicating such. tContractors that check this box retest attached an additional sheet showing the name of the sub-contractors and state whether or P01 dkM€;nfitie,, have employees. N the sub-contractors have employees,they must provide their workers'comp.policy number. Y am an employer Mag ig providing workers'compensadon insurancefor my employees. Below.,is The policy andjob 31P_ insurance Company Name: A.I.M Mutual Insurance Company Polioy#or Self-ins. Lie.MANAIC-400-7030025-2014A &pirafion Date: 9/30/15 job Site Address: City/state/zip: Attack a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 9231 of MGL c. 152 can lead-to the imposition of criminal penalties of 0, fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a,STOP WOR- ORDER and a fine, of up to$250.00 a day against the violator. Be advised diat a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance co-vera 'go P—AFY!io fl. 1 do hereby cerdfy under 9hepains an anoft6eels ariury that the informadon provided above is drue andcorre-et. 16 Sip Ltm Dme: c) 3 Phone#0 loto)&_7-tluall Official use only. Do not write in this area,to be completed by city or toon official, City or Town: permitgLicense,0 Issuing Authority(circle one)-. 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Co ntaci Person. 113s�en 0P iP F L DATE(MIk9/DDMT`J't) THIS GERT6P'9GATH I3 IwUR0 A3 A MAa31113 L)I A1 (jfl.�AIIk'i 0E.I4ji-i4i 14 KIGPId'y UPUN TON Ia K)'iF03ATP' Gdg.-DUPL'Fili 4 o P UFiA e ak'(a BUN'8 NOT AI=FRMA I IVLd'L m.7lm m&'iwij' P x h I,Cib oke imp4 I k i i-uI� 4joVERr 6E B'U 'I-ai P OLI�JV'8' 93ELOW. THIS CERTIFICATE OF INSUPAW3E DOES NOT I:>E W,3TI-0,rfI A C INI'k�WPI" PHTWErM THE ff,33 HIG A1:9rgORI? P RFS �E�9IA`'IVE�AIaI-I�&�kL3I m�E�3,�a��I� mtJP�m�tl Iaadli�91 aGa,BI � R R_TA_1jF. holdon an ADDIThi?JAL IIIAURED,LPmr 13erP.., mr3,,p Imist bo mcl vrx,d. Ir"319HROO.NT0,N� �a�( FSP rP9�IL�� €he terms and cmdiiions of the pollay,raRain I)OHPie.K UDIV V@g11h'e DIS GRIF.10113 1-41011f. . 0&401a-aeJat on P9iin corirfmcaie m w—s noc;omdev vigigs to Q�p CeriifIUarae holder irl Iiel.m of Such entlarsement J). PrQDUCCR NAME: Eviii MgLatigl p i 10up44vq X44"ela;y HONE820 Lynn fel Do parkwov Lue:781-f-W5,2775 iAA1, P Melrose,MA 02176 IsMA➢L 9�9v a E.McLaughlin Jr. ADDRESS: _ INSURER(S)AsTDRDWG COVERAGE NAIL c1 &NSUrdCR A;P OUtil"S i6'mS&.9i ante INSURF-13 Next step�=Ivinlj,Inc. — INSunEaac:Commerce Insisl'ance Cornpany21 ffiydock Avow e,2nd Nov v Boston,MA 02210cNSUREI�aa �k,9.iUi.Mutual Insurance Co. INSURER DAMS iisLlranc;e Company 15610 INSURER r: INSURER .: OBOE GES CEnTOFOCATE NUMBER..- - ------_ _ REVOS30m NUMBER. °PHIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOVV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 11F%1P INDICATED. NOTINITHSTANDINO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER HER DOCUMENT WITH RESPECT'I'O NJhIICH T 18 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE I114URANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN Is SUBJECT TO AL.L TI-IE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADUL SUOR POM CY EFF POLICY EXP LTR TVPCOFINSIJWWCC IMS13 MAIO POLOVNUMBER MMIDDIYYdY.L„ @. m_1 y_"_1) .____LIMI°rS A EACH OCCURRENCE $ CLAIMS-MADE Mt OCCUR > '��('>'d ' `d � l°Ibl (93 IyII/ OJ2'�Ic PREMI3E9jGaoccupnrei 19/I,800 MED EAP(Ary one Person)_ G 5,909 PERSONAL P ADV INJURY GENS,AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE fav"iPqTvPaii POLICY JEC LOC PRODUCTS-COMPIOPAGG $ vF9aM�i) OTIiER: G1WY42MODILC LIARIP.ITYOM®JNED SINGLE LTMIT c �� (Ea accident) v. s ANY AUTO 0�3MP11 KisFi KIdJ3,9h,)/20,dal 69/301_90i5 BODILY INJLIRY(Per person) qS AU 03 NED x SCHEDULED BODILY INJURY(Per accident) AUTOS MON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Peraccldent 0 Pr76RELLA L9AB �' �cocel i iRAr H n(!IJhf?EN!EEXCESS LIAR MS-MADE �ir4��������Q)`d�tEb �r3/��$/�1)`d� C)N/a�G)f��'I a AGGREGATE RETENTION r =_. ...� .m.�:-..... _. . . ...... �__ WORKERS COMPENSATION � STATUTE CRH AND EMPLOVERS LIABILI V V I N ANY OFPICEOPRI RIMETO ?ECUTIVE I_.__ NIA TIS SSE ISSUED D°/CARRIER dJf�I9f2OV, I 130/2015 E.L.EACHACCIDEN: LUD (Mandatory In NH) E.L.DISEASE-EA EMPLOYCf_' S Dl�ak�Il If yes,describe under DESCRIPTION OF OPERATIONS below m E.L.DISEASE-POLICY LIMITu .® -..-- --- �. .�.<.P�,_.......__. -...�.. .—.,. __ ..e...-.�..._ _....ear..:..:. ....,,._..�_. _110 DCSCRIPTBCN OI=OPCE'.ATbONJS/LOCATdONS!VCtrIICLES(ACOJ3D d09,AcJdi¢Ionai C3ornarvra Gctvode:Ps,6uRay ha arYaoFiad i"r rnrts•n sPaeo is:�q:�insd) I IR SN1FORtIAW—PION UNLY I CER`iIFIC'N E HOLDER -- --. --- CANCELLATION — 9i".ilud:)�19,a 0110UL D AN'V OV'All;I1I iV30VE,JE GGRIDE D POUCIEG EE:a,AMC LLC EJ LiFFORG T 91E EXINPATION DATE THEREOF, NOTICE TALL DE DELIVERED IN For Infor ,`'do Only ACCORDANCE IN aTH rI•IE POLIO,f PRGVN')v30M01. AUTHORIRCD REPREOEN rABdVE IkGORD COIRPO PATIMI, All 0gh'1 rr 7amaal. e R 25('0'1'1Q!) Alp 464"P§?Q1 3I���j��ma�kir' �'�o�c;�;��G £��i..I P;.P ACr)R .