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HomeMy WebLinkAboutBuilding Permit # 7/29/2015 i BUILDINGPERMIT eaoaarw Q`R.41.ED TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION _ Permit No# Date Received 7 QDRATED �SS�9CHU5�f Date Issued: IM ORTANT:Applicant must complete all items on this page LOCATIONS Print PROPERTY OWNER y Print 100 Year Structureyes no MAP °" PARCEL &� - ZONING DISTRICT: Historic District ye no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New BuildingOne family Addition ❑ Two or more family El Industrial El Alteration No. of units: ElCommercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ DemolitionElOther ., - �nraw .,,,� ori.,.�j�rv� ,✓auir(��'-,�, ;.lY,H,/ 0'%/ri//,�/� J.%// / „,aGi„f//01"1 %�./(.,,_d(✓J�//(f,',..� �,l/i ,/(!(;l , Y i �� �//�,; /r � ,.,,�''����pae�f�', y�,: lfl��%///,, ��/ ��!J ,y,� /✓/ - � d�C/,`+�f /G��/,1,",�� 1!� Wat�GS'`ed,I�.IS� ICt,/� �l r/ „r,��Se, +� ( ,,��ta�,,���afer�Sew„er��!,,t„� DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly °` ���VPhone: OWNER: Name: k. m � . Address: �: .. ���j 1 tj � e.. / J 4 ., b �/ Contractor Name: Phone: 4 Email: E .. Address: 74 1)(c ,,'k— .,. s WIL Supervisor's Construction License: A Exp. Date: ® � ? Home Improvement License: /� Exp. Date: f ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULD/NG PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ Y= FEE: $ L' Check No.: r Receipt No.: ` 1 11 ' NOTE: Persons contracti g with is e contractors do not have access to the n r nd n t4ORT H ver own of (% LAKE h h ♦ el' as17' COCNIC ME MACK 1' V S U BOARD OF HEALTH Food/Kitchen PER T D Septic System r THIS CERTIFIES THAT „(,4!I ;a BUILDING INSPECTOR has permission to erect............. ..... ... building S on .. .!... ; . . ,,,,. �,,J,,,,,,,,,,,,,,, Foundation � ( 1��� Rough to be occupied as ....... t. ....... .. ....°`?�► .......... .......................................... Chimney provided that the person accepting this permit s 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 E I E IN 6 MOK4TH ELECTRICAL INSPECTOR 3C), LESS CONSTRUCTI S 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. fF; next step Living® home energy solutions - This agreement is made by and among Rhea Simon Next.Step Living,Inc.("NSL") 21 Drydock Avon up,:2nd-floor 64 Phillips Cmn, Boston,MA 02210 North Andover, MA 01845 phone: (866)867-8729 Site ID: 419081 24-Jun-16 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 reoommendatfonshvork 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-scription (1 !Air Sealing Recommendations $680.00 Work Location: Attic Flat , Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 8 $85.00 Hr $680 d0 Weatherization Recommendations $1,581.05 Work Location: Attic Flat Replace Bath Fan Nose 1 $50.00 Each : $50.00 Attic'Stalr Cover Thermal Barrier vvith Carpentry1 $237;65 Each $237:65 Damming 104 $2.05 ' Lnff $213.20 Propavent 2'%:orEach 4'. . $a $1 X8:00 Attic Floor Open Blow Cellulose 7" 644 $1.30 sci t $837.20 1Nork Location: . 'Doors Door Weatherstripping w/Sweep 1 $75'00 Each $75.00 i L Initial Investment: $2,261M Airst3aling'Incentive up:to Program MaX $680.;00' 75 %IlVeatherizatiot7`:Incenfive up:to Program Maio $1,18 ?79 Total Not Investment: $395.26 Estimated AnnT:i:taal Energy Savings fro'm.the Above improvements 2. BLYMENT, CUSTOMER agrees to pay NSL for the work as follows: Payment#1: $100.00 -A non-refundable Deposlt by credit card(Mastercard,Visa,or Discover card)Is due at the time the Work is scheduled.Required payment information will be collected at the flme of scheduling. Deposit Isnot to exceed 113 of the total contract cost.. Additional Payments and Final Invoice: $295.26 -Additional payments for the Work shall be due upon completion of the Work and will be charged to the credit card on file within 24 hours of delivery of thwPinf involve.if this credit card charge Is declined for any reason,upon notice from NSL you will be responsible for providing valid alternative credit card Information necessary to complete payment stomer signature bats ---"J~ 24 Jun 2015 Alden Young NSL Signature Date Name of NSL Representative A1094962 The Terms of this Agreement are contained on both sides of this page Next Step Living o 21 Drydock Avenue 2nd floor•Boston,MA 02210•(866)867-8729-Inquiry@nextsteplivinginc.com,www.nextstepliving.com TERMS OF AGREEMENT 419081 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 IiEGISTHMIQN 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. S.PERMITS NSL will be responsible for obtaining any necessary permits as the Customer's agent. Customers who secure their own permits ordeal with an unregistered contractor will be excluded from the Guaranty Fund provisions of the Home Improvement Contractor Law. 6.PE�iEQRMANCE OF TUE 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,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 ourweatherizatlon 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 66 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 theContract the work elements thatneed adjustment,or setup a separate contract for.performing the adjusted work. 6.5 NSL represents and warrants to the Customer that(a)the materials and equipment fumished 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 modifiicatlon 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:INJURANQ.E AND WIDIRATION 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 WORD 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 orwithiri any longer period as permitted or required under applicable law,provided NSC has received final payment as provided herein: 9.PRE-EXIUING COCONDITION$&P)70PERTY 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-theright 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 bilis 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 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 falls 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 Agreemantfornms 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,ENEVY 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 CQNCI RNiNG SPQN1011 SHIP. 12.1 Customer understands and acknowledges that NSL is not an agent,vendor or sub-vendorof 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 RISE Engineering (RISE)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 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 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 R 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 email sent or by delivery,not later than midnight of the third business day following the signing of this agreement. Planview Diagram Customer Spt-IE{ Advisor Name: Address Qq N--rs rMa Advisor Phone #: Town Any limitationso access by truck? Site ID G�i,�o�( �� 6 NOTES Any work scoped outside of Best Practices? Approved by: QQ__-- / 2ttaftcc � 1 3 T=iaa(-Ia � pry+-���.�, Lam. fv_�.�6� �aa�' ✓ S 7" �gc � z V �Bo2 �� C tlr� DQE dr= 104=��-anl -- ✓ r-- a3 LY 204 I v N O ' J+ �"'1 J The Commonwealth of Massachasefts Department of Inelustrial Accidents u ®ice of Investigations ' d I Congress Street, ,Suite 100 ' W Boston,MA 02114-2017 �qM_ 3vi4V m jf assegovldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (I3tasiness/Organi7ation/lndividual): Next Step Living Address: 21 Drydock Ave City/State/Zip: Boston, MA 02210 Phone#:(866)667-6729 Are you an employer? Check the appropriate box-, 'type of project(required): I.* I am a employer with 650 4. ® I am a general contractor and I 6. ®New construction employees (full and/or part-time).* have hired the sub-contractors 2.® I am a sole proprietor or partner- listed on the attached sheet. 7. ®Remodeling ship and have no employees These subcontractors have 8. ®Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.t 9. ®Building addition required.] 5. ® We are a corporation and its 10.�Electrical repairs or additions q ] fficers have exercised their 11. 3.® I am a homeowner doing all work o tight of exemption per MOL ®Plumbing repairs or additions myself. [No workers comp. p p 12.®Roof repairs insurance required.] t c. 152, §1(4),and we have no 13.X Other Insulation employees. [No workers' _ comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not tho 3e entities have ' employees.,If the sub-contractors have employees,they must provide thea workers'comp..policy number. I 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. Lie.#: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 MOL 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage v ft tion. I do hereby certify under the pains ared pees perjury that the information provided above is true and correct Signature: Date: I C) l /� Phone#• ) 77 Official use only. Do not write in this area,to be completed by city or town official. City or Towne Permit/License.# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M. NEXT$=1 OP ID:EL CERTIFICATE F LIABILITY INSURANCE DATE(MMIODIYYYY) 10/01/20`14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CN�Y AND CONFER$ NC? RIGHT§ UPON TH9 09RTIVICATP HOLDER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AI-TER THE COVERAGE AFFORDED BY THE POLIPIES BEl,()VV. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIM RFP FSENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMP HTANT: If the gertificate holder Is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed. If SUBROGATION Iq 1NAIV91%whlep$t9 the terms and conditions of the policy,certain policies may require alt endorsement, A statement on this certificate does not confer rights to ghp certificate holder In lieu of such endorsement(s), PRODUCER NAMEACT Erin Lyons MgLaughlin I surance Agency PHONE.oExt:701.605.2775 FAX No):751=605=02 826 Lynn fel�s Park{BraY Melrose,MA 02176 EMAIL John E.McLaughlin Jr. ADDRESS: INSURER($)AFFORDING COVERAGE NAIL 0 INSURER A:Nautilus Insurance INSURED Next Step pving,Inc. wsuRERB:Cormmerce Insurance Company 34754 21 Drydock Avenue,2nd Floor Boston,MA 02210 INsuRERc:A,I,M.Mutual Insurance Co. INSURER D: IS 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 FERN 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, INSR TYPE OF INSURANCE DOL U 1) POLICYNUMBER IAMILODY EFF MMIDDY EXP LIMITS LTR A X COMMERCIAL GENE(4AL LIABILITY EACH OCCURRENCE $ 1,000,000 ® ECP2010198-12 09/30/2014 09/30/2015 DAMAGE TO E TED CLAIMS-MADE OCCUR PREMISES Eaoccurrence $ 190,000 MED EXP(Any one person) $ 0,000 PERSONAL&ADV INJURY S pg, 9 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JEC El LOC -PRODUCTS-COMP/OP AGG $ ,QQQ,�pO OTHER: $ _ AUTOMOBILE LIA811-ITY COMBINED SINGLE LIMIT $ 1,60-60 Ea accident �. B ANY AUTO �MMBGICI�DM 09/30/2014 09/30/2015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS � AUTOS 1BODILY INJURY(Per accident) $ NON-OWNED PROPERTYDAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB X I CCC IR EACH OCCURRENCE $ %000tQ@ ® EXCESS LIAe rl CLAIMS-MADE E�U783547012014 09/30/2014 09/30/20155 AGGREGATE $ 0.900-099 DED I I RETENTION$ $ WORKERS COMPENSATION PER 0TH- AND EMPLOYERS'LIABILITY STATUTE I ER C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN O BE ISSUED BY CARRIER 09/30/2014 0/30/2015 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,desedbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS f VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) FOR INFORMATION ONLY I 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 6 ���� ©1986=2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014/91) Tip AoQpp 9@M@ 4�rgj IRgg;are r9gjgQ�� r Q.f ACORP. gnonsu' mer a �a 10 Parr plaza o Suite 5170 Boston9 Massachusetts 02116 Home Improvement Contractor Registration Registration: 162111 Tvpe: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 DRYDOCK AVE. 2TH EL BOSTON, 11 A 02210 Update Address and return card.Mark reason for change. Address [j Renewal [j Employment E] Lost Card ^/w V" F,,FTrbr ari«^d . Ar ad.'to' �d"C`s CaOee of Consumer Affairs&Business Regulation )License or registration valid for individul use only before the expiration date. W round return to: '-HOME IMPROVEMENT CONTRACTOR P w Office of Consumer Affairs and Business Regulation `i Registration: 162111 Type: 10 Park Plaza-Suite517D 1141Expiration: 1/14/2017 SupplemeN Csrr,I Boston,MA 02111,6"'( NEXT STEP LIVING INC. ROGER OUELLETTE 21 DRYDOCK AVE.2TH FL — BOSTON.MA 02210 lindersecrelary �ot^valid without signature M as h u s eft S Depar"Irnent ot �Jwbhc Safety fIc�an,l of Bud&,,ig Regkflafirws and �`3twvlivd!, kit r Sjwcfidt'� ROGER A OVELLET 55 STANMORE Wganddc RAT 0280 Restricted TO: CSSWC-lnsulation Contractor Failure to possess a current edition of the Massachusettis State Building Code is cause for revocation of this license. For BPS Licensing informatiOn visit: WWWAOSS-GOVIOPS