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HomeMy WebLinkAboutBuilding Permit # 6/16/2015 BUILDING IT ®� o pT"�� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION o .." " > Permit NO: �� Date Received °`"""`" L ��ssgcwu5���� OArED Date Issued: 'IMPORTANT: Applicant must complete all items on this page le ,PROPERTYOWNER � Print VAP�NO: PARCEL ZONING:DISTRICT ,, Historic�District ' yes no w 'Vachine'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- "t. Sec WWIIFloodplain . Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Identification Please ype or Print Clearly) OWNER: Name: Phone: Address:16� ah-2t ut U . CONTRACTOR Name: Phone: " 1 Address ` m „ Su erviso s Construction�License p " p Ex, Date.1. Horne'I,mprovement License: . 1� �' Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ / FEE: $ Check No.: d Zo 2,J Receipt No.: _ NOTE: Persons contracting with e e ed contractors do not have access to the a nd Signature of Agent/Owner Signature of contractor - t%ORT#y f;'4 Town of ndover ® No. I,, �O LAKE ver/ aSS' A COCHICH@WICK � A0"?-ATER To S � BOARD OF HEALTH mmm LD Food/Kitchen Septic System THIS CERTIFIES THAT ....... $kn16kr 1014 BUILDING INSPECTOR ....................... .......... . ... ................ ............................ Foundation has permission to erect .......................... bu Ings on ...�. .�......... ...................... ............ ................. �� )) Rough to be occupied as . .�1/... ... ........ ....... .....I/........�.�,�c ... ............................. Chimney provided that the person accepting this permit shall in every respect conform to the t sof 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 IN 6 MONTHSELECTRICAL INSPECTOR LESSqtn CONST TIO ARTS Rough Service .. ................................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Buildinh 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. r� Living. home energy solutions This agreement is made 6� and among' ' Next Step Living, Inc.("NSL") Nancy Bartlett 21 Drydock Avenue;2nd floor 101 Prescott Stp .-Boston.;MA,o221Q North Andover, MA 01645 phone.' (866)867-8729 Site ID: 417122 30-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 recommendationstwork order describing the work in detail(the"Work")which are Incorporated herein by reference: ® . . e Lo 0 0 Work Location: . Attic Flat Perform Air Sealing at Estimated 62.5 CFM60 Per Hour 6 $85.00 Hr, $510.00 , • s to .. Work Location: Attic Flat Damming24 $2.05 Left $49.20 Replace Bath'Fan Nose 1 $50.00 ` ach $50 00 Propavent 2'or 4' 46 . $2.00 Each $92.00 Atttc'r=loor Open Blow Cellulose 432 $1'.3Q sgft $661:80 1Nork`Locatrt3npundation Insulate Rim Joist With 2"Thermal Barrier Polyiso 104 $3:52 sqft $366.08- 0 ,Alrseahngatic�(ltive,up to:Program Max $510:00 75%Weatherization ncentie up to Program Max '$839:16 ; Estimated Aniul energy Saving$from the>Above mpr®V®menta $1E7.00 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 she eduled.Required-payment information wiil be oolleated over the phone by a custOmor 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: $179.72 :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,fhe eustomer,service representative that you are paying by check and your card will not be charged unless we fail to receive payment within 6'dbys of invoice:' Cus omer Slgnai re ate / 30 Apr 2015 Alden Young NSL Signature Date Name of NSL Representative A1002611 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 417122 3.PROPOSED START DATE AND COMPLETION SCHEDULE NSL will contact customer to schedule the Work at a mutually agreeable time,subject to the avallability 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 lo: Office of Consumer Affairs and Business Regulation,Ten Park Plaza,Suite 5170,Boston,MA 02116.617.973.3700. 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 modlfical{on'of this Agreement Aall fie binding unless it is in writing and signed by all parties. 63 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 Wodi'that impacf the availabllity 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 CContract the work elements that need adjustment,.or setup a separate contract•forperforming.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 Customerthat it has a valid,Home Improvement Contractor Registration(No.162911)and the_necessaryinsurance required by applicable law and normally maintained by prudent contractors in R's(leid,inclµd(ng,bufnotJ{mited to,Workers Compensation Insurance for all employees who wrlPperform Die Work 8 QUALITY OF WORM NSL agrees that the Work will be per(ormetl 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 orwithin any,longer,Period as permitted or required under applicable law,provided NSL has received final payment as.provided here.{n:, 9 Pki-EXISTING CONDITIONS&°a —OkkT- -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 remedlation is complete, 9.3 While NS12will make best efforts to protect any propertyof 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 commencementpf the Work. 16.GkERAL 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 falls.to pay NSL as provided herein, 10.2 This Agreementshall be construed in accordance with the laws of the Commonwealth of Massachusetts 10.3 This Agreement forms the complete Integrated:agreement between NSL andCustomer Ttie;parties,reptesantond warrant that{n executing th(s Agreement;they are not relying on any representations,warranties or terms other than as expressly contained hereln. Thi§Agreement supersedes all.rlor'egreements iietween the Customer and Contractor and may not be altered absent a subsequent wntten adreementsigned by both parties,- ` You may cancel this Agreement if It has.0en 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.del!verynot later than.m(dnlghtof the third business day following the signing of this Agreement See the.attached notice of cancellation form for an explanation of this right. 11 EN ROY FIENE,M. The Sponsoring UtilltyC6mpany(the Utility)is entrtId&I[6100°A of the energy benefits associated with all Energy Consb vatloh,Measures,excluding the value of energy cost savings by the Customer,but including all rights to all associated ISO-NE Energy,Capacity and Reserves Product9.,:NSL agrees to provide,the Utility with such further.documenlOgn 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 ih6,'event`of the failure of arrenergy conservation device to pedormas 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 i hatsoev4 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 Contractoror._for.any,and;all;damages to property:or Injuryto,persons caused by the,: energy conservation measures.. 13 LIMITED TIME OFFER The prices and Incentive offered in this Contract are subjeclto change in accordance with The Sponsoring Utility Company Mass Save Home Energy Seivices 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 orby delivery,not later.than midnight of the third business day following the signing of this agreement, Mass Save PlanviewDiagram Customer H,A-MGa /F2r'z -ii Advisor Name: Address l Advisor Number: e6d '(eEic Town P4 AN Any limitations to ,access by truck? Site ID _ '(I7 17L-L / (, NOTES G) & pt OF I SSC � t � Ott- 23 6 lZI Ifl' 2 � 444— - $ �G�f The Commonwealth ofMassachusetts Department of Industrial Accidents ®ice of Investigations ' a 1 Congress Street, Suite 100 F Boston,MA 02114®2017 5� wwi.mass.gov/dta Workers'Compensation Insurantce Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Next Step Living Address: 21 ®rydock Ave City/State/Zip: Boston, MA 02210 Phone#.(866)867-8729 Are you an employer? Check the appropriate box: Type of project(required): 1.�]! 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 g, ®Demolition working for me in any capacity. employees and have workers' insurance.t 9. ®Building addition [No workers' comp.insurance comp. 10. Electrical repairs or additions required.] 5. ® 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 MGL 12.®Roof repairs insurance required.] t c. 152, §1(4),and we have no Insulation employees. [No workers' 13.®Other 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 aflidal it indicatbig such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or vol those ontities 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 insuranceTorr my employees. Below is the policy and fob site information. Insurance Company Name: A.I.M Mutual Insurance Company Policy#or Self-ins. Lie.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 v fi'9dtion. I do hereby cep Wfy under the pains and pen s .perjury that the infor`nadon provided above is true and correct Si ature: Date: Phone#:4 )90-7 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 S.Plumbing Inspector 6.Other Contact Person: Phone#: 0: onsume .' 10 Paris Plaza o 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 DRY® CK AVE. 2TH FL BOSTON, MA 02210 Update Address and return card.Mark reason for change. F] Address [-] Renewal E] Employment LostCard %'�a, V"G hs �raa�acir+�d8�a'r FEl a ,�nadr,wa,�u,(� office of Consumer Affairs&Business Regulation ]License or registration valid for individul use only 1 HD�/1E IMPROVEMENT before the expiration date. If found return to- Office of Consumer Affairs and Business Regulation a' Registration: 162111 Type; 10 park 'laza-Suitt 5170 Expiration: 1/14/2017 Supplement Card Boston,MA 02116' }NEXT STEP LIVING INC. ROGER OUELLETTE 21 DRYDOCK AVE.2TH FL BOSTON,MA 02210 flindersecretarro ;4lot valid without signature I Massmous etts Department of Safety Ro,,v'd of Hukfirig FZegWatw)ns ancl Standards Constructigon S"Kiptl"I i'401' SPINANAkI, wense CSSL-102811 LL�ETT ROGER A OVEiv L 55 STANKORE Way °c Ril 02M (0911,312016 Reetricted To: CSS WC-(insulation Contrador Failure a®possess a current edition of the Massachusetts State Building Code is cemuse for rewmation Vd this license. For DP5 Licensing intormation visit. vmJII`J.M@ss-Gnv/DPS NEXTS-1 OP ID:EL CERTIFICATE F LIABILITY I OATE(MMIV) 10/01/120142014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ®NAY AND CONFERS NO RIGHTS PON TH9 CORTIPICATIE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ASTER THE COVERAGE AFFORDED BY THE POLICIES BELOVY. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), 4"THORIZEP R9P PSENTATiVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMP RTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION Ig WAI1(AQ,§lIItL116#$9 the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to$)(p certificate holder in lieu of such endorsement(s). PRODUCER DAME CT Erin Lyons McLaughlin Ippsurance Agency 828 Lynn feps ParkWpy A/C No Ext:751=665=2775 (Fvc No,761=66502 Melrose,MA 02175 F-MAIL John E.McLaughlin Jr. s: INSURERS AFFORDING COVERAGE NAIL€! INSURER A:Nautilus Insurance INSUREDF�ext Step I°iving,Inc. INSURER B:Commerce Insurance Company 3470 21 Avenue,2nd Floor BostonSton,,MA 02210 INSURER C:A.I.M.Mutual Insurance Co. MA INSURERD: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 PffR(® INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI 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, ILTR TYPE OF INSURANCE DOL BR POLICY NUMBER POLICYEFF MMIOLP LIMITS A COMMERCIAL GENEUAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MAUI ®OCCUR ECP2010198=12 09/30/2014 09/30/2016 DREMAMAGES Ea NT ence $ 140,00 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1'0091 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ V100100 POLICY❑JECTPRC- LOC PRODUCTS-COMP/OP AGG $ �,QAQ,Qp PRO- OTHER: $ AUTOMOBILE LIABI{.(TY COMBINED SINGLE LIMIT $ Ea accident ,. IS ANY AUTO 14MMBGKKOM 09/30/2014 09/30/2015 BODILY INJURY(Per person) $ ALL OWNED IX SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000 00 D EXCESS LIAR CLAIMS-MADE E6UYI 3547012014 09130/2014 09/30/2015 AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PEROTH AND EMPLOYERS'LIABILITY X STATUTE ER C ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N TO BE ISSUED BY CARRIER 09/30/2014 00/30/2015 E.L.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? El N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 DEesSCdescribe und'r RIPT ON OF OPERATIONS below E.L.DISEASE.POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remart(s 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 For Information Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE -------_____ ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014191) 9fACOR%