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HomeMy WebLinkAboutBuilding Permit # 6/9/2015 II BUILDING PERMIT O�"�oT 6�ti l TOWN OF NORTH ANDOVER 0a APPLICATION FOR PLAN EXAMINATION �( aR 41 Permit No#: �1e Date Received �, ADR°"""`"pP °y � A7ED ` SSACHuSE� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION 711 ,�`1`(� ;Pant PROPERTY:01NNER-,,� �` ` ti „. Pnnt = i0o Year Structure yes MAP ' PARGEL ZONINGDISTRICT: Hisforic Disfnct yes IVlachine,ShopVillageyes 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` d Well D Floodplain 'El Wetlands ❑ Watershed District E Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name:_T4 Y,,� Phone: Address: Contractor Nan e1' Phone: ' 81 Supervisor'sConstruction License._ xp Date Home Improvement License." �ll 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: Check No.: 6 1 , Receipt No.: '`,- NOTE: Persons contracting with u 'st contractors do not have access to�&Verag Signature of Agent/Owner ignature of contractor ®RTH ' irown ot ndu v er O ,t-• _ -z _ �„K. h ver, ass, coc ICHEWICK y1' �® RATED BOARD OF HEALTH Food/Kitchen R MMM I IF Septic System • THIS CERTIFIES THAT 1............. BUILDING INSPECTOR .. .. ...... .... has permission to erect gJ�II� L-4• Foundation .......................... buildings .. � ..... . ......... ........................................... • Rough to be occupied as ... .... ..... �.. ..........1.�C'*1 +r^...................................... chimney provided that the person accepting this permitall 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 u Final PERMITEXPIRESI TH ELECTRICAL INSPECTOR UNLESS C Rough - r Service ........... ......................... ..... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® ccupr 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. cnext step Livir*ig lam", This agreement Is made by and among Next Step Living,Inc.("NSL") Rita Anderson 21 Drydock Avenue,2nd floor Boston,MA 02210 107 Granville Ln phone: (866)867-8729 North Andover, MA 01845 1i1- A815343 17-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: Woik Location: Attic Flat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 8 $85.00 Hr $680.00 oir \Noik Loc,ition: Attic Flat Attic Stair Cover Thermal Barrier with Carpentry 2 $237.65 Each $475.30 Damming 90 $2.05 Lnft $184.50 Vent bath fan to soffit exhaust 2 $118.75 Each $237.50 Propavent 2'or 4' 53 $2.00 Each $106.00 Attic Floor Open Blow Cellulose 4" 764 $1.13 sqft $863.32 Vvmk 1.ocafion: Mise Re-lay existing fiberglass batts in bays 764 $0.25 sqft $191.00 100%Airsealing Incentive up to Program Max $680,00 75 %Weatherization Incentive up to Program Max $1,543.22 ISHIM11100100HEM IMEMMIZE11= Estimated Annual Energy Savings from the Above Improvements $137.00 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: $414.40 -Additional payments for the Work shall be due upon completion of the Work. Apr 30, 2015 Customer Signature Date C4 17 Apr 2015 Andrew Carpentier G,hvisdna E.conomou(Apr 20,2015� NSL Signature Date Name of NSL Representative A815343 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 o www.next. tephyLn 2 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 be responsible for obtaining 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,NSL's 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 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 Wok will be free from defects,and(c)that the Wok will conform with the description of the Work described in Paragraph 1, 6.6 NSL may determine in the course of pre-installation Technical Review that modifications are necessary to the scope of Work in order to ensure professional quality of the Installation. In the event of such modifications,NSL will request a written modification of the Agreement to be signed by all parties.In the event that Customer and NSL cannot agree on the modification,the Agreement may be terminated by either party. 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 one 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 unfit 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 retying on any representations,warranties or terms other than as expressly contained herein. This Agreement supersedes aft prior agreements between the Customer and Contractor and may not be altered absent a subsequent written agreement signed by both parties. 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. 12.1 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. 12.2 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. 12.3 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 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 fax,or by e-mail sent or by delivery,not later than midnight of the third business day following the signing of this agreement. Mass Save Planview Diagram Customer (Z,'.LA Advisor Name: A/j,jnew Address 10 -7 Advisor Number: q-7 Town )V, /j,4JoL/c- Any limitations to access by truck? Site ID A- 5-,7 �1 -3 NOTES q + - o U, 14 -L�) The Commonwealth oflMlassachusetts Department of°Industrial Accidents W ®ice of Investigations ' d 1 Congress Street, Suite 100 a w Boston, MA 02114-. 017 www-mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Nae (Btasiness/Organization/Individual)e Next Step Living Address: 21 Drydock Ave City/State/Zip: Boston, MA 02210 Phone#:(866)867-8729 Are you an employer? Check the apps opriate bozo Type of project(required): IA I am a employer with 850 4. ® I am a general contractor and I employees(full and/or part-time).- have hired the sub-contractors 6. New construction 2.® I am a sole proprietor or partner- listed on the attached sheet. 7. ®Remodeling ship and have no employees These sub-contractors have 8. ® Demolition working for me in any capacity. employees and have workers' coin insurance.t 9. ®Building addition [No workers comp. insurance p° 10.[J Electrical repairs or additions required.] 5. EJ We are a corporation and its 3.® I am a homeowner doing all work officers have exercised their 11.®Plumbing repairs or additions myself. [No workers' comp. right of exemption per MCL 12,®Roof repairs insurance required.) t C. 152, §1(4),and we have no employees. [No workers' 13.® Other Insulation comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t homeowners whe submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new aflida,it indicating such. tContracters that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or coot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. 11 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. 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 WORD 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 yollfiqdtion. I do hereby certify reader the pains and pen es penury that the information provided above is true and correct. Si ature: Date: Phone#:( otq)6-07-9-7019 Official use only. deo 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#: NEXTS-1 OP ID:EL CERTIFICATE F LIABILITY INSURANCE DATE(MMIDD/YYYY) 111111111/20114 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONI-Y AND CONFERS NO FIGHTS UPON TH9 QERTIFIQATr HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EX'T'END OR AFTER THE COVERAGE AFFORDED BY THE POLICIES 8EI,01N. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED ROP RSENTATiVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ,NIR RTANT: If the gertificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIV99:0H621a61a$9 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). CONTACT PRODUCER NAME: Erin Lyons MULou9hil"I surance Agency HOONN En4:7>81-665.2775 ac Ne:781 a665.02 828 Lynn fells ParkWay EMAIL Melrose,MA 02176 John E.McLaughlin Jr. ADDRESS: INSURER(II)AFFORDING COVERAGE NAIC 0 _ INSURER A:Nautilus Insurance INSURED Next Step�Iving,Inc. INSURER B:Commerce Insurance Company 3475 21 Drydock Avenue,2nd Floor INSURERC:A.I.M.Mutual Insurance Co. Boston,MA 02210 INsuRERo: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 RgRg INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICF�T}}1II 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, INR TYPE OF INSURANCE DD R POLICY NUMBER POLICY EFF MMIUDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ® ECP2010198.12 09/30/2024 09/30/2015 DAMAGE TO TED 0 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ 190,000 MED EXP(Any one person) $ 01900 PERSONAL&ADV INJURY S 11099,09 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ �,QpO,Qp POLICY F—I JjECT LOC PRODUCTS-COMP/OPAGG $ , pQ,ppR OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 00p,0p0 Ea accident s. B ]ANY AUTO 14MMBGKKOM 09/30/2014 09/30/2015 BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR I X I Of:CI IR EACH OCCURRENCF $ 5,000100 D EXCESS LIAB CLAIMS-MADE E�U783547012014 09/30/2014 09/3012015 AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION jt 7-7 AND EMPLOYERS'LIABILITYvim STATUTE ERH C ANY PROPRIETORIPARTNERIEXECUTIVE Y� TO BE ISSUED BY CARRIER 09/30/2014 05/3012015 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) FOR INFORMTION 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 /y�o ©19882014 ACORD CORPORATION. All rights reserved. ACORD 25(2014191) TIIO Agggp ggMR@AAgqp�qr of AC®R Oieke of Co' nsu r ffai ani. Business regulation 10 Park 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 EL BOSTON, NIA 02210 Update Address and return card.Mark reason for change. Address F] Renewal F] Employment E] Lost Card _,. /Z, 6 orrrxa€° ar✓�6r��c o- /�etisra�✓ ,l� Ofliee of Consumer Affairs&Business Regulation License or registration valid for individul use only i ,,HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return toe Office of Consumer Affairs and Business Regulation Registration: 162111 Type: 10 Park Plaza-Meseta 5199 Expiration: 1114/2017 Supplement Card Boston,MA 02116,, NEXT STEP LIVING INC. ROGER OUELLETTE 21 DRYDOCK AVE.2TH FL -- BOSTON,MA 02210 Undersecretary ) of,valid without signature M as s aw h u set,t s Depwrfinen� �,jt ��Iubhc Safety Boafd of Bw�dmg Rlegkflafions and Standwds, Surwr�iqor sjwr,Jak� CSSL-1028tl ROGER A OVEL�LET )jU 55 STAMMORE 023w) 09§1312018 Rastdcted To: CSSWC-insulation Contractor Failure to possess a current edition of the M,assachusGUS State Building Code is cause for revocation of this license. For OPS Licensing information visit: www-M@ss-6,AV/DPS