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HomeMy WebLinkAboutBuilding Permit # 7/21/2015 7 Of FORTHBUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received— TED Date Issued: IMPORTANT:Applicant must complete all items on this page I LOCATION Pr,int PROPERTY OWNER I Print 100 Year Structure yesn Qo MAP PARCEL--�M�ZONING DISTRICT: Historic District yes no Machine Shop Village yes. no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential [I New Building [I One family 11 Industrial [I Addition [I Two or more family 0 Commercial [I Alteration No. of units: [I Repair, replacement El Assessory Bldg [I Others: El Demolition [I Other DESCRIPTION OF WORK TO BE PERFORMED: DESCRIPTION , Q ent*fi ation- Please Type or Print Clearly 7)1,,1 'Ibn OWNER: Name: pnq Phone: Address: _A0 AL Phone: Contractor Name��*e Email: ( ) Address:2,1, ;I)L( I In J Supervisor's Construction License: Exp, Date: «i1113#1169 Home Improvement License:— ..—Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDINGPERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 0 FEE: $ Check No.: Leo zx Receipt No.: NOTE: Persons contracting wit t red contractors do not have access tot q a tyfund t6nature6f Aq'ent/O FORTH Town of ndover No. 0 %6--ablJ5 0 T C' LAKE h h vel' aSS� 1 44 D I a 61 coc NIc NEWICK y1' A0RATEO P?P�.�5 , Nook IJ BOARD OF HEALTH ij E RM I �T L D Food/Kitchen Septic System THIS CERTIFIES THAT • I BUILDING INSPECTOR has permission to erect .......................... buil 'ngs o � �.1��.... Foundation ..... ..... ..... .... ♦ Rough W. • tobe occupied as .............. ... ............. ...... ...., . ...!!.1.......................................... Chimney provided that the person accepting this permit sh I 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 Final PERMIT I E IN 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRU I ST RT Rough Service .............. .............. ................................................ Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® 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. next step Living, home energy solutions This agreement is made by and among Nancy MacMillan Next Step Living, Inc.("NSL') 21 Drydock Avenue,2nd floor 75 Woodcrest Dr Boston,MA 02210 North Andover, MA 01845 phone: (866)867-8729 Site ID: 418816 01-Jun-15 I. 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.Pricing reflected below may be subject to adjustments In program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed. 1•scri.tion.' rivestmOt Air Sealing Recommendations $680.00 Work Location: Attic Fiat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 8 $85.00 Hr $680.00 Weatherization Recommendations ,_ Work Location: Attic Flat A Replace Bath Fan Hose 2 $50.00 Each $100.00 Attic:-tair Cover Thetmai Barrier with Carpentry. 1 $237:65 Each $237:65 Work`Locatiort Misc Sheathing Access 1 $31.31 Each $31.31 Work Location: Foundation Insulate Rim Joist With 2"Thermal Barrier Polyiso 33 $3.52 sqft $116.16 Initial InvestrTient: $1,165.12 100%Airsealing"Incentive up.to Program Max $680,00 75 %Weatherization Incentive up.to Program $363;84 Total Net Investment: 77 i=stimated Annual Energy Savings from the'Above lmproveiments $93:00 2. AP YMENT: CUSTOMER agrees to pay NSL for the work as follows: Payment#1: $100.00 -Credit card or 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: $21.28 -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 the customer service representative that you are paying by check and your card will not be charged unless we fail to receive payment within 5 days of invoice. f� Cuso rsignature Date 1 Jun 2015 Edward Yaracz NSL Signature V, Date Name of NSL Representative A1091485 The Terms of this Agreement are contained on both sides of this page Next Step Living 21 Drydock Avenue 2nd floor^Boston,MA 02210 0(866)867-8729 a Inquiry@nextsteplivinginc.com o www.nextstel)llving.com next step living® home energy solutions This agreement is made by and among Nancy MacMillan Next Step Living, Inc.("NSL") 21 Drydock Avenue,2nd floor 75 Woodcrest Dr Boston,MA 02210 North Andover, MA 01845 phone: (866)867-8729 Site ID: 418816 01-Jun-15 1. DESCRIPTION OF LAORK 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.Pricing reflected below may be subject to adjustments in program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed. Description Other Recommendatiolls Work Location: Attic Flat Recessed light boxing (Not Rebate Eligible) 2 $31.25 Each $62.50 7777777-7777777=777---- Initial Investment: $62.50 Not Rebate Ehgibie' • Estlmatetl Annual Energy S"nos from the Above mprovemenfs 2. PAYMENT.- CUSTOMER agrees to pay NSL for the work as follows: QA $f Payment#1: 4$50,W Q Additional Paymen an i I In�ioi e: $`1'Z'� !Additional a ment f rth Work all be due u on completion of the Work(I i custo Signature Date 1 Jun 2015 Edward Yaracz NSL Signature Date Name of NSL Representative A1091485 The Terms of this Agreement are contained on both sides of this page Mass Save Planview Diagram Customer �� c� N`cxc itau� Advisor Name:, Address 1� LJo��c Q.%;a qzx- Advisor Number: Town Any limitations to access by truck? Site ID L� I ga. ► _ ..�� NOTESAS r \ po, .I 1� CRi �a� �rtca�L a QO\ � Q33 .J J AN 0 1 1,0 ) �� -A i rI �;� The Commonwealth ofMassachusetts Department of IndustrialAccidents u Office of Investigations a d I Congress Street, Suite 100 a Boston,MA 02114-2017 www:mi ass,-nvIdid Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Appl HEFTS-1 OP ID:EL CERTIFICATE OF LIABILITY I DATE(MMIDDIYYYY) 10/01/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON�y AND CONFER$ NO RIGHTS UPON THU OPTIFIOATP HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AFTER THE COVERAGE AFFORDED BY THE POLIOIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RSR FSENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION Iq WAIVCR,0012j@6$$q the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to$hp certificate holder in lieu of such endorsement(s). PRODUCER NAME CT Erin Lyons MGLaughliglp�sufancoArncy HONE 020 nn fella Parkwiity Ell:781-665-2775 ac No: �E1=666=0� Ly Melrose,MA 02176 E-MAIL John E.McLaughlin Jr. ADDRESS: INSURER(S)AFFORDING COVERAGE NAI£0 INSURER A;NaUlt1IUS Insurance INSURED Next Step pving,Inc. INSURER B:OOmmerce Insurance Company 3475 21 Drydock Avenue,2nd Floor INSURER C:A•I.M.Mutual Insurance Co. Dolton,MA 02210 INSURERD:AXIS IFiS1APSnGB Company 16610 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 PER1Ie13 INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICll THIO 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. iTDSL SUBR DY EFF POLICY R TYPE OF INSURANCE POLICYNUMBER MMNMMDLIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR ECP2010198-12 09/30/2014 09/30/2015 pREM SES Ea occurrence $ 100,000 MED EXP(Any one person) $ 0,000 PERSONAL&ADV INJURY $ 9, GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT � 1-1 LOC PRODUCTS-COMPIOPAGG $ OTHER: $ Ea accident AUTOMOBILE LIABI[.JTY COMBINED SINGLE LIMIT S 1 000,®p0 s. E ANY AUTO 14MMBGKKDM 09/30/2014 09/30/2015 BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS PROPERTY OWNED $HREDAA $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 6,000100 D EXCESS UAB CLAIMS-MADE E�U783547012014 09/30/2014 09/30/2015 AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION }( 0TH- AND EMPLOYERS'LIABILITY STATUTE ER O ANY PROPRIETORIPARTNERIEXECUTIVE Y� TO BE ISSUED BY CARRIER 09/30/2014 00/30/2015 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 ' TT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 1131,Additional Remarks Schedule,maybe 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 ©1900=2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) i jACORIR F � . Office COn��111f�I1�� �f�°ai d Business Regulation 10 Park Plaza e Suite 5170 W, Foston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 162111 Type: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 ®RY®GCK AVE. 2TH FL BOSTON, MA 0221 Update Address and return card.Mark reason for change. Address F] Renewal n Employment F] Lost Card /`ri.r' P a,her>r€✓.,�o ,*to'd� .,/ R�s „rr:Ft�✓e„r4"d; Office of Consumer hffairs&Business Regulation ]License or registration valid for individul use only i- ®YUIE IMPROVEMENT CONTRACTOR before the expiration date. W found return to: Offfiee of Consumer Affairs and Business Regulation �r Registration: 162111 Type: 10 Park)Plaza-Suitt 5179 � Expiration: 111412017 Suppiern ni Card Boston,BBA 021 NEXT STEP L!V)NG INC. ROGER OUELLETTE 21 DRYDOCK AVE.2TH FL -- BOSTON.MA 02210 Undersecretary otwalid without signature Departn)en� of flubhc SaftAy of Rth�kfinq Regiukat�on , anc,"l har7dards CSSL-102811 ROGER A OVE4 LLET "E 55 STANMORE, �O Wanidek R11 028w) 09§1312016 Restfttad To: CSSWC-ffisulation Contract©r Failure to possess a current edition d the Massachusetts State Building Code is cause fa r revocation of this license. For OPS Licensing Information visit: UJUMMUSS-GOVIOPS