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HomeMy WebLinkAboutBuilding Permit # 6/4/2015 g%ORTH BUILDING PERMIT of TOWN OF NORTH ANDOVER 0 PLICATION FOR PLAN EXAMINATION _A � n y Permit No#: Date Receiveday'�RarEo SSAC HUSH Date Issued: I ORTANT: Applicant must complete all items on this page LOCATION PROPERTY OWNER �rtQ t ri t �'o Pnnt =100 Y6Br Structure yes MAP � PARGEL OM ZQNING�DISTRICT Historic 's," y s n ti Machine Shop Villagey 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 q Septic ""'Well „ O Floodplain :O Wetlands ❑ Watershed District 0 Water/Sewei"ti. , DESCRIPTION OF WORK TO BE PERFORMED: I� � �I vv2t 4-° )1� -l � Identification- Pleae Type or Print Clearly OWNER: Name:� � j�� Phone: Address •, /V. Y J ' Contractor Nam 1 hone: Supervisor's:Construction License ate Exp: D : Home,lrnprovement License: / Exp: Dafe;` 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: $ il FEE: $ N -® Check No.: r Receipt No.: NOTE: Persons contracting ith g' r cl contractors do not have access to the I f nil Signatureof Agent/Owner Signature of contractor :- FORTH Andover _E Town v ® ta+ ® ver, Mass, L( r � c Oc HIc Mlw.c. `S U LBOARD OF HEALTH PER M IT �T� Food/Kitchen Septic System BUILDING INSPECTOR .. . ... THIS CERTIFIES THATL .......... ........... ....... ...... ....................... Foundation ..................... buildings on ...... ......... has permission to erect ..... ........ ...... .....................�............. `� Rough tobe occupied as ......... ..... .. L. .� ...... ...w�............ . .......... .. ...................................... Chimney provided that the person accepting this perm hall 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 EXPIRES3J. PERMIT MONTHS ELECTRICAL INSPECTOR UNLESSRough Service ........rTTARTS .......................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Oceupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final ® Lathing or all To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. Z2. next step IIVing® home energy solutions This agreement is made by and among' Next Step Living, Inc.("NSL") Laurie Carabello 21 Drydock Avenue,2nd floor 23 Autran Ave Boston,MA 02210 phone: (866)867-8729 North Andover, MA 01845 Site ID: 416188 08-Apr-15 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: Description • $340.010 Work Location: Attic Flat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 4 $85.00 Hr $340.00 Weatherization Recommendations i • Work Location: Attic Flat Hatch:Thermal Barrier Polyiso 2 inch(Attic) 1 $60.00 Each $60.00 Vent bath fan to.roof flapper 1 $118.75 Each. $118.75 `i� -Attic Floor Open Blow Cellulose 9" 424 $1,43 sgft $606.32 Install 2"Thermal Barrier Polyiso on Open Kneewall Slope 351 $3,31 sgft $1,161.81 y tlrt�d .... . Anti�iI1rYiJ(ns fPCn'fh A lrt� roy . pova� �rr,eht� 5th ao 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: $418.41 Additional,payments for the Work shall be due upon completion of the Work. ustomer SignatureDate 8 Apr 2015 Elizabeth Venuti NSL Signature Date Name of NSL Representative A869192 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 a www.nextstepliving.com TERMS OF AGREEMENT 416188 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 02116.617.9730700. 5.PERMITS NSL will obtain any necessary permits as the Customers agent. Customers who secure their own permits ordeal 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 shuatton 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. T.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 fn NSL's field,including,but not limited to,Workers Compensation insurance for 811 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 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 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 mechanics 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 ata 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,Customers sole recourse is to Contractor and not to RISE Engineering(RISE) or to the Utility.The Ufillty 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 Contractorto install the proposed energy conservation measures. Customer agrees that it shall not hold RISE,the Utility,their affiliates or operating companies liable for Contractors 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, Mass Save Planview Diagram Customer .)gjc Advisor Name: a � SCP, �zz Address _ Z�dnLMzr- Advisor Number: Town gogvrN I4N(Zkf!r,— Any limitations to access by truck? Site ID W0198 NOTES ►Q MINS I` Vx 11nC: CAr (g2g5() 4 Mks WX:(PINSUI.W 6 14ASH fSYI) 2r' no(,y 03 b►gmmlw" Ir, / Q veNT PP t2 To goof fLarr' , i ,/ CN2H rC) w/ 91,o�L ®INS. kW swp& w12"Pmq (2s9pf) 3Si�C +OqrN0 POLY I'Tb Iaa f'y RjVCIn0-^j CSep p mac r ®INS. &w" wnus w/2- Poo4 (2 p(� , stop lam—-- 28 l2 . to IO IZr N X DQU Nor CpmwoNIERM wI ti IIIF1114 AMC,CCR? (8► �1 41 , w&iweu Aj;ws ® I TD+hN►Stt IVIS I 1 lifkr tresriot' GRIP 9 ww-Kr to t1,�aT IV2' WS g ® qV v � y b' The Commonwealth of Massachusetts Department of pndustr al Accidents W Office of Investigations d I Congress Street, Sulte 100 Boston, MA 02114®2017 pry.It��y ,/ry Workers' Compensation Insurance Affidavit: ®ullders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Next Step Living Address: 21 Drydock Ave Citi/State/Zip: Boston, MA 02210 Phone#:(666)667®6729 Are you an employer? Check the appropriate box-, Type of project(required): 14 I am a employer with 650 4. ® I am a general contractor and 1 6 E]New construction employees( full and/or part-time).* have hired the sub-contractors 2.0 I am a sole proprietor or partner- listed on the attached sheet. 7. ®Remodeling ship and have no employees These sub-contractors have g, ® Demolition workingfor me in an capacity. employees and have workers' Y p �'• 9. ®Building addition [No workers' comp. insurance comp. insurance. required.] 5. EJ We are a corporation and its 10.El Electrical repairs or additions 3.0 I am a homeowner doing all work officers have exercised their 11.®Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.®Roof repairs insurance required.] t• C. 152, §1(4),and we have no Insulation employees. [No workers' 13.E Other _ comp. insurance required.] *Any applicaut that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Ilomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new aflidal it indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not thMe 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 insurancefor my employees. Below is the policy and job site information. Insurance Company Name: A.I.M Mutual Insurance Company Policy#or Self-ins. Lic.M AWC-400-7030025-2014A Expiration Date: 9/30/15 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage v fi tion. I do hereby certify under the pains aspen es penury that the information provided above is true and correct Si ature: Date: 1Q/ 11 /4 Phone Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License.# Issuing Authority(circle one): 1.Board of health 2.Building Department 3.City/Town Clerk 4.(Electrical Inspector 5.Plumbing Inspector he Other Contact Person. Phone#. NEXTS-1 OP ID:EL CER T7 I T LIABILITY INSURANCE DATE(MMIDDIYYYY) 10101/2014 [THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON4-Y AND CONFERS NO FIGHTq UPON THV CpRTIFIGATP HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEN®, EXTEND OR A@�PER THE COVERAGE AFFORDED BY THE POLICIES SEI DW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRAST BETWEEN THE ISSUING INSURER(S), AUTHORIZED REP FSENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMP F��ANT: If the gertificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION l�1NAIYR- ,Qu 091$q the terms and conditions of the policy,certain policies may require an endorsement. A statement an this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT MOLau hlin Ipsea anc0 Agency NAME: Erin Lyons 9 I 0 y PHONE.oExa:701=665-27'5 Ac,Nn:9O1-665=02 828 Lynn fells Parkwpy Melrose,MA 02176 EMAIL John E.McLaughlin Jr. ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL 0 INSURER A;Nautilus Insurance INSURED Next Step�Iving,Inc. INSURER B:Commerce Insurance Company 3475 21 Drydock Avenue,2nd Floor Boston,MA 02210 INSURERC:A.1.M.Mutual Insurance Co. INSURER D:AXIS Insurance Company 15610 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 PgRq INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T I& 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, TR TYPE OF INSURANCE DL BR POLICY NUMBER POLICY EFF MOM MMIID(pY_EXP LPM LIMITS A X COMMERCIAL GENEPAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR EVP2010198-12 09/30/2014 09/30/2015 D7WArOlTO'RE TED PREMISES Ea occurrence $ 1Q ,000 MED EXP(Any one person) $ 01900 PEkSONAL&ADVINJUR-Y S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY a PRO- JECT FILOC PRODUCTS-COMPIOPAGG S OTHER: $ AUTOMOBILE LIABI),ITY COEa aMBINED SINGLE LIMITccident S ^,. ®p® . B ANY AUTO 14MMBGKKOM 09/30/2014 09/30/2015 BODILY INJURY(Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY(Per accident) $ X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA UAB I X I CCCUR EACH OCCURRENCE $ 5,00OIQ0_ ® EXCESS UAB ri CLAIMS-MADE E�U763547012014 09130/2014 09/30/2015 AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STATUTE ERH C ANY PROPRIETORIPARTNERIEXECUTIVE YIN TO BE ISSUED BY CARRIER 09/30/2014 GQ/30/2015 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? F__]IIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000 Use describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) FOR INFORMATION ONLY CERTIFICATE HOLDER CANCELLATION INFO-01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Information Only ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE Ak 15� a✓al� ©1900=2014&CORD CORPORATION. All rights reserved. AC®RD 25(2014191) Th0 ApQftR ril1R prbj I9go are rqqo4( p,9f ACORN. 0` Office of Consumer Affad'and Business Regulation �r� 10 Park ]plaza � ����� ���� Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 162111 Type: Supplement Carol Expiration: 1/14/2017 NEXT STEP LIVING INC. GER OUELLETTE 21 ®R��1(gDOCK AVE. 2TH FL BOSTON, MA 0221 Update Address and return card.Mark reason for change, Address [-] Renewal F-] Employment n Lost Card G' , F� 44" Office of Consumer Affairs&Business Regulation (License or registration valid for individul use only �.w HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation n F' Registration: 162111 Type: 10 park plaza-Suite 51?D Expiration: 1114/2017 Su lement Card pp Boston,IYdA 02116,, NEXT STEP L)V)NG iNC. ROGER OUELLETTE 21 DRYDOCK AVE.2TN FL ----- BOSTON.MA 02210 Undersecretary Not valid without signature M ass x h�A setts De�,,mrtrnerO ot Satety of Budcl�ng Regulahwr,, -,�nd Standards Cc,itts I r,u c fif i n Su rkt,r%w%o r Spe c i f(�,#I v CSSL-102811 IT , ROGER A OVELLET ,]G" 55 STANMOREE Roi Wotit ek RFf 0280 09§1312016 Restricted To: CSSWC-insulation Contractor Failure to possess a current edition OF the Mhassachusetts State Building C(Dde is cause for revocation of this license. For DUPS Licensing 1007matiOn visit: %4"JuJAWS-GOVIDPS