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HomeMy WebLinkAboutBuilding Permit # 6/4/2015 BUILDING �1 tfORTF♦ �l � '1� PERMIT ,..� a 41 TOWN OF NORTH ANDOVER ° o ^P-',�' abs APPLICATION FOR PLAN EXAMINATION * - .. 1 q [, 4b 111 / Date Received '� °q `•" � Permit °RArlD Date Issued: �SSgcHus�� IMPORTANT: Applicant must complete all items on this page °LOCATICON 77`/Z 'Print' PROPERTY OWNER, rl6, ✓'G i d Print ` MAP NO: PARCEL; ZONING DISTRICT: Historic District,' yes LqW Machine Shop Village yes n TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 7 New Building X, One family Addition L Two or more family Industrial Alteration No. of units: Commercial Repair, replacement L Assessory Bldg Others: d" aemolition ❑ Other Ei Septic .D Well ,Ci Floodplain EI Wetland, Yatershed District El Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: It �'� e=��� Phone: Address: ��i°Z � � . Pc4i q i s CONTRACTOR'Name: Phone:, ,�® Address: - Supervisor's'Construction icense: :Ekp. Date: Horne ImprouementLEcense; Exp. .Date ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST LASED ON$125.00 PER S.F. Total Project Cost: $ 3,? FEE: $ � "— Check No.: Z- Receipt No.: '�-1 �I NOTE: Persons contracting with unregistered ontractors do not have access to the uaranty.fund Signature of Agent/Ownerignature of contracto _ ro..... V% 2 °R�� Town of �,.ndo.,N e r 0 lil. No. -� _ = _- _ � 261 h � ver, Mass, h a '� 0 LAKE I�, �� COCNIC Nl WICK � AoRATE o l•4�` '�y 9S U BOARD OF HEALTH Food/Kitchen Septic System ....... ... ..... BUILDING INSPECTOR PERMIT eo �.�, -!........................ THIS CERTIFIES THAT . .... """' ............................. � .......... Foundation has permission to erect .......................... build'ngs on ........ .. Rough Chimney to be occupied as ... ' ' .................. .... . Final provided that the person accepting this permit shal l ry respect con form to the terms of thAltepat onl and on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final ELECTRICAL INSPECTOR PERMIT EXPIRES 16 MONTHS LESS COSTRCTI ST S r Service .............. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildin Rough Final Display in a Conspicuous Place on the Premises — Do Not Remove FIRE DEPARTMENT No Lathing or Dry Wall To Be Done Burner Until Inspected and Approved by the Building Inspector. Street No. Smoke Det. Vie:,�► ���� �q �6� � CONTRACTOR CC)r)s!r% a�t�r� Services Group 50 Washington St.Suite 3000 Printed: 5/8/2015 Westborough,MA 01581 Work Order Id: S85914P89062C332 Contractor Information Customer/Site Details ESE Erica Mcewing Email: ericamcewing@comcast.net 742 Winter St Phone(Eve): 978-687-8793 52 Fitzgerald Dr Phone(Day): 617-359-7662 Jaffrey,NH 03452 North Andover,MA 01845-1417 Site ID: S00002085914 Total Installed Measures' Location Description Quantity Unit$ Total $ Living Space Attic Stair Cover Thermal Barrier with carpentry 1 $260.23 $260.23 Door Sweep 5 $23.18 $115.90 Living Space Perform Air Sealing at Estimated 62.5 CFM50 8 $84.32 $674.56 Exterior Door Weather Stripping 2 $27.59 $55.18 Attic Propavent 2'or 4' 90 $3.83 $344.70 Living Space Hatch:Thermal Barrier Polyiso 2 inch(Attic) 1 $41.71 $41.71 Damming 64 $2.19 $140.16 Living Space Kneewall Floor Enclosed Cellulose Dense Pack 356 $2.60 $925.60 Living Space Attic Floor Open Blow Cellulose 6" 888 $1.47 $1,305.36 Installed Measures Total $3,863.40 WorkOrder Notes Payments Incentive Payments Weatherization Incentive $2,000.00 Air Sealing Incentive $1,105.87 Total Incentive Payments $3,105.87 Customer Share Total Customer Share $757.53 Less Deposit Of $252.51 Customer Share Balance(Due Contractor) $505.02 Conservation Services Group-50 Washington Street Suite 3000-Westborough, MA 01581 -(508)836-9500 RCS PLANVIEW DIAGRAM 16 Customer: Cr CCAGL:w 1 .Home Phone: ! Address: W t �� --- Work Phone: ( 1- Town: dou of Cell Phone: ( �- Any limitations for access by large truck? No ' Yes If yes,describe: Any specific directions or landmarks? No `'/ Yes if yes describe: 7L,G"zil 14 Energy Specialist: �jT et1C'dl �2CC( Q� Reviewed by: Site ID:� Air Sealing: 8 hrs (888 sq. ft.); Attic Stair Cover Thermal Barrier with carpentry 5 Door Sweeps and 2 Weatherstrips 90 1. Propavente 64 ft. 2. Damming: 3. Attic Floor Open Blow Cellulose Xrr fi4: 888 sq. ft. 4, Kneewall Floor Enclosed Cellulose Dense Pack 8": 156 sq. ft. 5. Hatch: Thermal Barrier Polyiso 2": 4 BF 2 BF O BVH z 4 Z 2 � • • I � 2 � i o a 40 For Office Use Only Bushes ladder Neighbor Proximity Pocket Doors Insert Radiators Fence(s) Vents Note Inside Square R=Roof S=Soffit G=Gable Existing Conditions X=Access l]=VenCDE=Continuous Drip Edge T=Triangle RV=Ridge Vent CS=Continuous Soffit W=Wall S=Sheathing Temp Unless Noted Otherwise Install O=New Access Note in Circle C=Ceiling M=12"Mushroom For Access =Vents Note in Triangle R=8"Roof S=Soffit G=Gable Rev 1/14 T RAC,fO mass fir^ Gf @f"�#'�"aY`rK PERMIT AUTHORIZATION )� ERICA MCEWING ,owner of the property located at: (Owner's Name,printed) 742 Winter St NORTH ANDOVER (Property street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. X (� Owner's Signature 2. Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: �r�i �/VL w -��y l� Participating Contractor Date td i Rev.12132011 ky,, Me (ornurrrrrwetrlth cr/Altrssitc'huselts n.� De )trrtmernt t " rtt rr� rrcr� c�c'itletr. r f a 1 Congress Street cite 100 Bcrsmu, 114 021152017 r; a HIM,rrrtrs'� �,xt))r�`tlitr 0 i aarhers' Coraapensation tlasaarance."'f davit f3laifaters/( oota actor lh,lca tricisans/1''Irrraa ear s tORE t ILIA)"IIII�t ttt,lat"ettt"t'NNG,%t"' 1")ttl"t`l. ..... ret ;o►ttr s,t�irrr� _..._.._.__ -_ _.__,. _.. _ lnt N alTaa. (tfu�Rult 0 ulwatloll, lld1%,1elual V ESE INC, Mom 52 FbgwaW Di Cttwi�ifeltaf�ip Yfle�y NH 034526035321346I'Ittnac �� \r'r you:err crarplrarcr.`Check IIIv arppw trpurie later, 1 rpe of protect trealnn•cd) �;� `j ��� "rlCwti a teR9`.tlt6Ct,trrll { I +rel a a•n�l',lrr,a�+�,vlth _s ntl,lr,�era°,r(ufV arnrl n 1r,ait-;utter I rtrr a •rale°1mrlrne-too ter p.+rnRe^rrdregr ortei hx'e no vmpl aea ew1:1 �eru6.an feta ra�rr in eyEl lt.e'naeaeldltl;,' arcle r�tR'eBrerle ["�r rtuu'halrry 'x01111III'M WC tore{+epee°J{ l El J)c 111trIEtR<'�I'i Matte,hore7oawonct,I„ur(�.rlle"'0'otr,wlt ':over lomttmw'tt re'lu edI' itdElyt�rlRli,IUMe' tte:)aI11,rUlt �f arae a hurorcr,rrr,-'I',rrtu9 e"W fx'h1tow come r41,rr°,t,e,.r e duct all Notl m lite luwlrent deal! l ( l'.Ia'e`(rlc,n9 rcpR'41RC",t rtC aCfifttirrit 110,111+snerrucuu^r nfre^r lr w"Mws ,tt,reep lemon unm amu e,r me"'I, t i 1rr,yrrrutnr°,wthIII,etrrp1mck", l '" r 1 l�lllYill}Ott Cl".l1,RIC,t1R dVCIt.IEUUiI r� "M a,Icncra(e'ctintrue t,rr and A hara,Inrce!rite ;rdr-crunrl�ecrurrvlr,i nig the autaerdrwrf i,hrrci 3 �l' ekl Y1 14'1.1.11 I Ilcstl wuh-,6rrrtnlcr�rr,h;arc enlplur cu�tartci bore e.eor6 a�r. aomy, att,utarrc"� $ ,, t)(lat,r Ilt`itllrlt1C)IV __ _ as I'mj! I'ltI0It a IJ o, ottl ee V ave: rM Rte�,l,�,crnpUun p>cr MI'l h4l surd v.rr hove°Ito reaap{e>e,r�; (; �,w„�r6.cr:, ,on1l, ulhkrr,uacea areloeu ! 6 — — --- '11” apple our Ilrat r bu 4;:•Parr rt l litre t�ale1 9ic�,rtlrreltlace ater—1 it 17t,ivairtrt .ail e+�,rh.rml rdrera hu lean wup� a urrte.n ee+i�,nw I wnrur�t tie , el hd'le 1t rra.Vecatier •rte 1, O lm al ernes. Check 01u R(uv alMrIl xl e rnitru,'rrus that e'hccP,rhe.w dvur�rnreea;rra,rcdecr,l art addeuaruel•:he�err nVuraerrrl Ihc�rsarurr<rillac',r+(,r�xrare,r,rr. ries.l.,.al,�sch,rttr,�r�vr eu>t tlr�,,u,.err Ie,� catllttrt 'T, 11 the rrb..c:enitruct r hae�cr„�r�sl�lr,�va tlr0” t pIo �.rdre.rr .er eke( ct�mr p pule,; moat r r _ :w !elite an eeniplt?ve'r that is lar'aadetitrg no,erntr/ut areas, h�0m, us the policy(111rt/orb site r. ig10r'rnatiot National C tt�al)llity & Fire InInsuranceCompany lnm" ante•lrete I'Ira PV ataa< _ 3/8/2016 4/pVVC;C3294,q2�) _ _ L,rY9 _1�/�.,,�_ �/t�sti�� I f )I eta `*ia`.l l-Iia`; I.RG I _ f- e? _�,,. .._ .._._.... ..._. (. 1 r ''wt Ilt r✓IjrAl !.'e rV. !.'..�. !r l 111t: Aff of the a� .�h �a�eaas; 7 a DATE(MM/DDIYYYY) ACC> CERTIFICATEI I I INSURANCE 4/27/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Karen Shaughnessy FIAI/Cross Insurance PHONE , (603)669-3218 FAX, (603)645-4331 AICNo 1100 Elm Street ADDRESS:kshaughnessy@crossagency.com INSURER(S)AFFORDING COVERAGE NAIC p Manchester NH 03101 INSURERA:West American Insurance CO. INSURED INSURERB:Oh10 Security Ins CO 24082 ESE, Inc. INSURERC:Ohio Casualty Insurance Company 4074 Energy Saver Enablers INSURER D'American Alternative Insurance 52 Fitzgerald Drive INSURER E: Jaffrey NH 03452 INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 All w/ 15-16 WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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. INSRTYpE OF INSURANCE ADDL BR POLICY EFF POLICY EXP LIMITS LTR I R WVD POLICY NUMBER MMIDD/YYYY MM/DDIYYYY GENERAL LIABILITY EACH OCCURRENCE _$ 1,000,000 fDAMAGE TO RET 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence $ A CLAIMS-MADE r_X1 OCCUR BKW55684497 7/31/2014 7/31/2015 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 '.. GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC CMBINE $ ',..'',... AUTOMOBILE LIABILITY Ea accidentSINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AS55684497 7/31/2014 7/31/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS IAUTOS Per accident '. Uninsured motorist-combined $ 1,000,000 X UMBRELLA LIABX OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED X RETENTION$ 10,00 5055684497 7/31/2014 7/31/2015 $ D WORKERS COMPENSATION 2A2WC0000371-03 X SLA IT OEH TOR AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ANY (3a.) NH & MA E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? NIA 11 of included /8/2015 /8/2016 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Refer to policy for exclusionary endorsements and special provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of North Andover, MA 1600 Osgood Street North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Laura Perrin/JSC `) - ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025onlnnetnl Tho Ar'OPn nnmo and Innn aro ronictororl mnrirc of Ar.OPr) Massachusetts Depaarlrunent oPnNauluc Safety Board of B uflddng Regutl alrcrrm and Standards t.oriru%tmaaarihawan Suupnema-uuwr 6_ic,ense: CS-072318 CALEB AHO 9" a 48'2 JARMANY HULL' SHARON] i ;�uuosa.utu�rn nuanvnrus n rnr unr 12/18/2015 z I Office of Consumer Affairs and Business Regulation , 5 f% 10 Park Plaza - Suite 5170 w,ro Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 161406 Type: Individual Expiration: 10/20/2016 Tr# 258803 CALEB ANO CALEB AHO 482 JARMANY HILL RD. SHARON, NH 03458 Update Address and return card.A1ark reason for change. Address Renewal Employment 1.,ost Card SCA a C"J N"0-05M ✓� "�for� r�,r,eriu«,�6°�"�rr Rn(iri«rA,�,-//s Office ol't'ansnmrr AffairsBusinesslte Regulation I.Acense or registration valid for individul use only a M 'WOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: tegistration: 161406 Type: office of Consumer Affairs and Business Regulation Expiration. 10/20/2016 Individual 10 Park Plaza-Suite 51711 Boston,MA 0211.6 CALEB AHO CALEB AHOY 482 JARMANY HILL RC1, SHARON,NH 03458 Undersecretary Not valid will signature