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Home My WebLink AboutBuilding Permit # 6/16/2015 BUILDING P ITo�0°aT 1 TOWN OF NORTH ANDOVER �� '' o� APPLICATION FOR PLAN EXAMINATION00 l , � e« Permit Na# 1' Date Received ��SSwcHus�R�y Date Issued: IMPORTANT:Applicant must complete all items on this page / rr 0 /..r / �. / r,.✓..l...,,vi....Gri,r,,/,i t a,./.fi r, r,,/,/rri,r..r/,�ri r,,.,.rr ri r/r% ,.r.r.,,r�r..P:-.ir.m. rri,irz,/.../�i,/rr r�r r 2/1"'W', r 0 ;,reiicr Struc:, ue, r Y MAP , ,/% PARCEL/ r, ZONING DIST, CT-/A '' ' % Historic Distr�ctr r/i/ es no p / // ' r// „r///// rr/ri////, /,,, ;, rl! /r, /r, ;%'/'; '' Machine Shop V /r / illage 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 ❑;Septic ❑Well 0P o o b a ind:Wetlands '❑-Watershed, District a / r ,. „❑,Water/S ewer, DESCRIPTIO N OF WORK TO BE PERFORMED: r' kuhbL Identification- Please Type or Print Clearly OWNER: Name:`. ' y-xr- 1 C' I Phone: Address: Contractor Name / //��/ / r AddreSSdL�'/ , rr r /ioi a/ r 0/6- 1/18/ r �/��, , ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.•$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $4,- FEE: Check No.: 60 o 6 2, Receipt No.: NOTE: Persons contracting with re i er ntractors do not have access to tlae rt rad Signature of Agent/Owner Signature of contractor th®RT H Town of It T.." ndover ® 0 • 1b6l,-iJ5 T '- 7n y ge Mass, (` T ii o LANE 9 ass 9 COCNIC NE WICK 1' Vel S U BOARD OF HEALTH Food/Kitchen P R� M ITA Septic System THIS CERTIFIES THAT „ „ ,,,k, BUILDING INSPECTOR .. .. .... has permission to erect .......................... buildings on ... .. ........ ..........,.. ........ Foundation Rough to be occupied as ........... ... . ... ........!! ....... .....R.r.... .A.. /... chimney provided that the perso accepting this permit shall in every respect conform to the terms o e 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 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCSTAWS Rough Service ........ ..... .......................................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy 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 Approved by the Building Inspector. Burner Street No. Smoke Det. A next step l~v~ rq ~ This agreement Is made by and among Next Step Living,Inc. ("N8C7 � Brian Hickey 21 DrydockAvenue,2nd floor � Boston,MA 02210 �2Fmrnunn �D ' phone: (866)867-8729 North Andover, MAO1846 � � ite !1): A203S27 2Q-May-15 ' DESCRIPTION OF WORK TO BE PERFORMED � NSLwiU perform or causeto be orfnmedthe following work on the customer's ddress above,in a professional manner andiouordonco with the terms of this Contract,including the attached recommendations/work order describing the work in detail(the"Work")which are incorporated hiPricing reflected below may be subject to adjustments in program pricing and offerings and is guaranteed for JOdays from the date the Contract|oprinted. � � � VVork LooaUon: Attic Flat � Perform Air Sealing sdEstimated O25CFM5OPer Hour 8 $8508 H *51000 � � VVorhLooaUun: Attic Flat � � Whole house fan box: Thermal Barrier Polyiso2" (Attic) 1 $20921 Each $20921 Damming 68 o2.05 Lnk $138.40 Pmpavent2'o/4' 57 $2.00 Each $114.00 � Attic Floor Open Blow Cellulose 8" 672 $126 sqft $84672 VVorkLone8on. Foundation Insulate Rim Jist with 6.25" Fiberglass Batting 62 $1.75 LnM $10850 VVurkLou�bon: Doom Door: Thermal Barrier Pu|yiao2"(Attio) 1 $7I91 Each $73.01 1OOY6Aimea|ingIncentive uphoProgram Max $518.00 75 Y6VVeatherizaUon Incentive uptoProgram Max $1.118.81 Estimated Annual Energy Savings from the Above Improvements $127.00 � � 2. PAYMENT. CUSTOMER agrees topay NSLfor the work oafollows: � PaymerK#1�� $iOOOO . � -Credit card o h k deposit is due at the time the Work is scheduled. information will oncollected over the phone hyocustomer omvo � representative at the time ofscheduling. Deposit ionot to exceed 1/3 of Die total retail costs.VVNaMasterCard,Visa,and Discover amcepte0 Additional Payments and Final Invoice: *272.83 � -Additional payments for the Work shall be due upon completion of the Work. Jun 1. 2015 / CustomerDat Signature— -- Courtney HGllV Jun 1. 2015 2yyW@y2O15 AndrevvCarpenUer � N@LSignature Date Name ufNSLRepresentative A293927 I � The Terms wf this Agreement are contained voboth sides of this page ^� � Next Step Living 21 Drydock Avenue 2nd floor-Boston,MA 02210-(866)867-8729-inquiry@nextsteplivinginc.com o � 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 fimes,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 concems. 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. 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 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 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 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. 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 Ufility 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 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 incenfive 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. Planview Diagram • Customer Advisor Name: Address _C� `� �� ► �° Advisor Phone : `Z - Town Any limitations to access by truck? VOTES Any work scoped outside of®est Practice? Approved by: 06 boo 164� �w � �� r OS Cf> !�a t� Wff 15+ a) CA L. Z` !� U b 141 k The Commonwealth of Massachusetts Department of Industrial Accidents r ®ice of Investigations a a I Congress Street, Suite 100 W F Boston, MA 02114-2017 5" www.mass.gov/dla Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Next Step Living Address: 21 Drydock Ave City/State/Zip: Boston, MA 02210 Phone#:(866)867-8729 Are you an employer? Check the appropriate box-, Type of project(required): 14 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. E]Remodeling ship and have no employees These sub-contractors have g, ® Demolition working for me in any capacity. employees and have workers' 9. ®Building addition [No workers' comp. insurance comp. insurance. # required.] 5. ® We are a corporation and its 10.n Electrical repairs or additions 3.® I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.E]Roof repairs insurance required.] t c. 152, §1(4),and we have no Insulation In employees. [No workers' 13.® Other s _ comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t I iomeowners whe submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicati»g such. tCoatractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or vot those ontitim have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workerrs'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.#:AWC-400-7030026-2014A 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 tip 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. Ido hereby certify under the pains and in es perjury that the information provided above is true and correct Si ature: Date: 10/ 11 /1 Phone#: wa)&Q-9-7d9 ®fficial use only. Do not write in this area,to be completed by city or town official. City or Towne 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#: � 0o esws '�ne� tai ani �usnn�ss Regulation 10 Farb plaza e Snits 170 Boston, Massachusetts 02116 Home Improvement Contractor Registrati®n Registration: 162111 "type: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 ®RY®®CK AVE. 2TH FL BOSTON, MA 02210 Update Address and return card.Mark reason for change. E] Address F-] Renewal 0 Employment LostCard l: ;+ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only 7 1 t1OME IMPROVLMENT CONTRACTOR before the expiration date. Iff found return too Offfice of Consumer Affairs and Business Regulation ' Registeetlesn: 162111 Type: 1!0 Park playa-Suit5170 Enplration: 1/14/2017 Suppiement Card Boston,ISA 02116„ NEXT STEP L)VING)NC. ROGER OUELLETTE 21 DRYDOCK AVE.2TN FL t3OSTON,MA 02210 tindersecretav� �Not valid without signature Massachi,isetts Di,:,�parirnenf of Pubhc Safety Board of Buddmy RegWafion,,, and Standwds ("al'I'struction SAIP4,"V"%uwI' specio"Ji'k Gwense CSSL-102811 ROGER A OVWELLET OV55 STANMORE MIN2016 Reeificted To: CSSWC-Msulation Contrador Failure to possess a curreM edition at the Massachusetts State Building Code is camse for revocation Va this license. For BPS Licensing Ift'i'Ormirtion visit. vjjppp3.M@ss.6nv/DPS NEXT5m1 OP ID:EL CERTIFICATE LI IIT I DATE(MM/ Y) 10/01//201201 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION O%y AND CONFERS NO RIGHT4 UPON TH9 09RTIVICATF HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AFTER THE COVERAGE AFFORDED BY THE POLICIES BKOVy. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AV.TH0ftIZ9p RSP �SENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION Ig WAIY9 the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to gllft certificate holder in lieu of such endorsements). PRODUCER NAMEACT Erin Lyons McLaughlin Ipsurance Agency 828 Lynn fells Parkway alc°No E,t:761-665.2775 761-66502 Melrose,MA 02178 E-MAIL John E.McLaughlin Jr. s: INSURER(S)AFFORDING COVERAGE NAIL€! INSURER A;Nautilus Insurance INSUREDxt Step I,.Iving,Inc. INSURER B:COmmerce Insurance Company 3475 NeDrydock MA0221®Avenue,2nd Floor Boston,MA INSURERC:A.I.M.Mutual Insurance Co. 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 PPR!®p INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T 19 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 21111-V&P DDL B POLICY NUMBER POLICY EFF ffg2R EXP on LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 ENTECLAIMS'-MAUI ®OCCUR ECP2010190=12 09130/2014 09/3012015 PREMISES Eaoccu ante $ 100,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 4+ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ �+QpA,QQA ❑PRO- POLICY 9 JECT LOC PRODUCTS $ �+QAQ+AAA OTHER: $ AUTOMOBILE LIAftlij COMBINED SINGLE LIMIT Eaaccident $ 1,a0A+®A0 B ANY AUTO 14MMBGKKOM 09/30/2014 09/30/2015 BODILY INJURY(Per person) $ ALL OS X SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000 Q0 D EXCESS UAB CLAIMS-MADE E�U783g47012014 09/30/2014 09/30/2015 AGGREGATE $ 0,00 , OA DED I I RETENTION$ $ WORKERS COMPENSATION PEROTH AND EMPLOYERS'LIABILITY X STATUTE ER C ANY PROPRIETORIPARTNER/EXECUTIVE YIN N TO BE ISSUED BY CARRIER 09/30/2014 00/30/2015 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-PA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remad(s Schedule,may be attached If more space is required) FOR INFO M T%ON ONLY CERTIFICATE HOLDER CANCELLATION INFO-01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For InformationOnly 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(2014/91) ThR ARRR n@MR pnq 199p ,are rqjstp,r94 tgk 9.f ACORR;