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HomeMy WebLinkAboutBuilding Permit # 9/11/2015 n 1 BU1E IN P R IT �orarH TOWN OF NORTH .ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No Date Received ry�A�RATED P4p`~Cy �SS'ICHus�� Date Issued: MPORTANT:Applicant must complete all items on this page LOCATION (> L fznt Print PROPERTY OWNER Print 100 Year Structure yes �o MAP/ PARCEL: �` ZONING DISTRICT: Historic District yes kno Machine Shop Village yes no r TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition El Two or more family El Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg thers: ❑ Demolition ❑ Other i... :r:� r;;./✓rrr irr r rf�,r r,/ ,,, .i„v7,%///i 1/r r,///t. ,r,rc � r�,r r /, .r r, I//6 fi� a A d/r// .,Ill,y%.�/✓/., rTf. / /_. �y ..r ,✓,� , r ii�r i,, i, �f/i ,%i�, �G/ ,,�, ,�%,,,9/�',„/ � �� edi � �strict�r/�,/, , �/ ��✓/�/r� , �, �/�!,Vii/ riff,, /❑,Flood r a�n � rri r r � 1/,� r rrr S.e ttc./ ❑Well/ r,1 //a / p o ` of r r h,„ r�N,f1/;//rir� /�; � �'r'%r";alH.a,✓r/�/r/ �///lI, ! Y/i �y'r;�u Il� �r � y� 1�f 'y ; /�; 1 /,f/„ ��v,.dl iNr���?� " DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: m tjA- 05 C t t D Phone: (-Q 95-`1q3 Address: 1 (e,5 AAL fb w✓ �► V I X0 X-1 I C9 LAO-C- Contractor Name: DU n rR'.JI-a- Phone: 24, q0.1- ?63 P Email: 7 L4- u`v t,- Address: r4j P.,A- !"fie � a ? 104 y U Supervisor's Construction License: I /�6,9f Exp. Date: Home Improvement License:9dlA,,t &-,,�A Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST IRASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $_ _ Check No.: G Receipt No.:_ �1 3 NOTE: Persons contracting with unregistered contractors do not have access to the gua n fund k _ __ - ®RTtynndover `�a�.T '' :_'�'' ® 0% —o�dl 11L ZT � -� ) I 'P O LANE Ver, ass, COCNICNEWICK A�4A"rED S U BOARD OF HEALTH Food/Kitchen PER IT D Septic System • THIS CERTIFIES THAT ,, 4„ BUILDING INSPECTOR .......... ........ .......... ............ .4 .p.......:. ............... . . .... .... . . ... has permission to erect .................... buildings on ....... .. .... .......... .P... .. .. .. .... Foundation Rough to be occupied as .......... .... .�... . . ....... ....... ............ .. .� .. ........................... Chimney provided that the person accepting this permit shall in every respect conform to the termT 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 IOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES I86THSj ELECTRICAL INSPECTOR LESS CT1 Rough Service ..... ........................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Oecupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathingor Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. li 11 1 Federal to#0"403629 t RISE Engineering RI Contractor Registration No 8186 tJ MA Contractor Registration No 120979 A division of Thiclsch Engineering _rZoobactoorpegistration No A20120 60 Shawmut,Canton,MA 02021 �ro C ' '• T "- + 339-502-5197 FAX 339-502-6345 Page ,.:-4 _. PROGP�ANI TJJIS CONTRAJ->=»RED INTO BETWEEN RISE - ENGINEERING CMA-NES ENGINEERING AND•TRE CUSTOMER FOR WORK AS DESCRIDED - PHONE DATE WENT WORK ORDER FSr.W.E Deprizio (9'38)IMAI436 05/2912015 41569'1 04042 TREET $iWNG STREET rSeton Lane 165 Carleton Lane SERVICE CITY,STATE,LP DI WNG CIN,STATE,LP North Andover,MA 01845 North Andover,MA 01845 1 a - 2011 JOB JOB DE-SC-t'`�. €'TION ' AIR SEALING:Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful ndn�r air quality.Materials to be used to sea)your home can include caulks,foams and other products. Primary areas for scaling:i* leakage to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) This will require(8)workingbours. A reduction in cubic feel per minute(cfm)of air infiltration will occur,but the actual number of cfm is not guaranteed. At the completion of the weatherization work,and at no additional cost to lite homcrnvner,a final blower door muffo-cut 3detY analysis will be conducted by the sub-contractor to ensure the safety of the indoor air quality. $680.00 AIR SEALING ADDER: (4)working hours. aj$-340.00DAMMING:Provide labor and materials to install a 12"layer of R38 unfaced fiberglass baits to(244)square€ purposes. ATTIC LLAT:Provide labor turd materials to install a 9"layer of R-32 Class 1 Cellulose added to(1076)square feet of open attic space. $1,538.68 .� ATC ACCESS:Provide labor and materials to install(1) easily moved,insulating cover for the attic access folding stair. A small- 20 surface of plywood will be created around the opening within the attic. This will allow die covers integral weather-stripping to restrict air leai:age. $237.6 VENTILATION:Provide labor and materials to install(1)insulated exhaust hose with soffit mounted flapper vent to exhaust existing bathroom fan(s). I - $118.75 ✓ rVENTILA:rION:TION:Provide labor and materials to install ventilation chutes in(105)rafter bays to maintain air flow. / $210.00 J/ ineering will apply all applicable,eligible incentives to this contractYou will only be billed the Nct amount. Currently,far eligible ,Columbia Gas oflcrs 75%incentive,not to exceed 52,000 per calendar year,and an incentive of 100%for the Air Scaling measures first$G80 and ana5340 if savings arejustified by Ihr.auditor. afety and health of your home's indoor air quality,we will be conducting a blower door diagnostic of the available your th before the work is begun,and alter the weatherization work is complete.We will also conduct a full assessment e tieion safely of your heating system and water heater."/tris has a value of$90 and is at no cost to you. Total allowable weatheriiation is$3,l l0. $90.00 Federal ID#05-0405629 IJSE Engineering Rl Contractor Registration No 8186 MA Contractor Registration No 120979 A division ofThicisch Engineering --CT ContraaarRegistration No62DY20 60 Shawmut,Canton,,11A 02021 CONTRA re.-T 339-502-5197 FAX 339-502-6345 Page _PROGRAIU ENGINEERING THIS CONTRACT ISENTERED RITOEEiY - CRA.HES ENGINEERINGANOTHECUSTOMER FOR WORK AS DESCRIBEDJ38T7N CUSTOMER PHONE DATE CLIENT WORK ORDER Donna Deprizio (978)685-4936 45129{2(515 415697 MMM- SERVICE STREET BILLING STREET 165 Carleton Lane 165 Carleton Lane i F:) c�� SERVICE CITY,STATE,LP OILLNG CITY.STATE,ZJP ' V I J — North Andover,MA 01845 North Andover,MA 01811 1 I I.1 jculir JOB B£SC-M-PI'ION -� ve: $3,03.96 Qmstomer _ l: $651.32 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS-Tn---.SUM OF ***Six Hundred Fifty-One&371400 Dollars $654.32 UPON FINALINSP ON AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%VALBE CHARGED MDNLTiON AN1`T"�--- UNPAID BALANC A R i- 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARAIITEES,RIGHTS OF RECISION,SCHEDUIJIIG,A4D CONTRACTOR REGISTRATION. DO NOT SIGN TN1S CONSRACT tf SNERE ARE ANY BLANK SPAC&S cu ems_ r� AUTHORPFD SIGMA RE-RIS inccring CUSTOMER ACCEPTANCE NOTTHIS CONTRACT MAY BE WITHDRA%VN BY US IF NOT EXECUTED WITHIN GATE OF ACCEPTANCE E ACCEPTANCE OF CONTRACT-THE ABOVE PbICES,SPFS.IFICA.TIOMS ANDLONEW"ONS ARE 30 SATISFACTORY TO US AND ARE AUTHORIMB-40 00 THE WORK DAYS. AS SPECIFIED.PAYMENT WILL BENAQ&A&ZU==NE-�BOVE T e Con V ?z ungol"wer'Itif of I I�gssaclz Useas Repaivizewr of 1jzdiv,,;,-IdIAcckIen,-s Off[Ce Of_7111'e-5tigatiO, Ij 600 T-I'la'sawtom S. I� AVIA 02111 worke-L's" co-antpelasait-1,1033 bwSara nee Atffidavft: Applignrzt Inforrnation Please Print Lecriblv D .Name(BLisint:ss!OQ-anizatiorL[Indi%-idual): lau— o, 7P—vL,5 raj i,o---P �!,a t n Address: 4 0 x C-1tv1swLe/Z.P: -P�— IM M' PI-ione aq 0A Are You ari enz pipyer?Check the appropirante bo z: Type o,Aprejea(required): I.rin't am a employer with 7 4- Q 1 am a general contractor and 1 6- RNew construction emyploees(Aill and/or part-Lirne)...Iz have hired the sub-contractors 2. 1 ama-sole Proprietor or partner- listed on the antaclied sheet. 7. Q Remodeling ship and have no employees These sub-contractors have 8- Q Demolition working for me in any capacily- emplo-yees and have workers' 9. Building addition [Noworke&comp.insurance comp.insurance-; required-] 5-E] We are-a corporation and its i 0-F-1 Electrical repairs or additions 3-Q 1 am a homeowner doing all work officers have exercised their I Ln Plumbing repairs or additions awself.[No workers comp. right of exemption per MGL 12.17 Roofrepairs insurance required-] c-152.§1(4).and we have no employees. [-No workers' 13-[ROther comp.insurance required-] 'Anvapplfcanithat checks bo.,c=I muitaiso m out iiieseciian hoo,,sha tving zhcirxvorkes conmensmion poffLr information. Ihitnt!aUTIZTS IMITC)submit this affidavit indicatinE they aredoing all-ork mid then hire outside contractors must submit a new affida"it indicating such- =Contractors that check this hos nuist nuached art additional sheet shoivin!z the utunc of ilia sub-contractor and state-Micilicror not those entities 11—C ertiplo-ve-es. if the sub-cantractors hate employees.they must provide their--vorkeni-comp.policy number- twz all g�wpfaygr t1j'a!ispr,91,1LgIn"Jpqrk-CJs,C,9j?7Pejj3-aj!0jj jqSjfr(,fjjCefGr 1771-eqjPjqVLYCS. &I01j,LS fire pojjjQV a12[ljob site Insurance CGnipanL,'tiarne: if ow Police--;'or Self-ins-Lie- v!Pf o Wf— 575,7 o Q_ Expiration Date: Job Site Address, Citvistate/Zip: Affach a copy of the Ivorkers-compensatiou puut., ,,ation pa,-,e(sho-,%,ing the policy.ritimber and expiralion date). Failure to secure coverage as required under Section 25A of_'VIGL c-152 can lead to the in-,position of criminal penalties of a fine up to SI-500-00 and/or one-year imprisonment-as well as civil penalties in the form of a STop WORK ORDER and a fine of up to 5250-00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of InvestiLeations of the DIA for insurance coverage verification. h--reh-l'cgN,-dJ'Wider rhe Plihis antlpeva ftles ofp erilla,111at Am 11101*111,7floji PI'OL'Idell above is ir"a jaml corre'et. yro "A 0 Dat Phone= r4j. 0frich7lUse eq'r. Do init write latAIT area,M be C-0111pleted by eiry or toitui oiTiciaL City or Town: Permit/Licen5e Or Issuing Authority(circle one): 1. Board of llenith 2- Building Department 3-Oti-fl-gwri Clerk 4. ElCMICal 1115pCCiOr i.FilyrriblTi-In5PCCt0F 6. Other Contact?Ierson: Phoned=- ^ f� •4 ;:,. r'z:: • r. r 1"• _ •" �'_ Y .;5� - }"1; 1. _ _ x '} r',r-1- •1,7. , 1711,F ,E .1, rm n-' 1°,n 1.. .,z._: .arr cu,,,--.r 'ter:. �Y - � 1+ a =rrr`r 'E 1 '1'� '[. a-�'1' .. r• a + !r ri :hsz Ir W s i`.-spl- era 1' .°E` '�i•,i i ' ,�. _�t.• r-'. sir". --,. -fr mss-,+r �).� 'l •:.i �" ( ! 1 tl1 :_� • :SII`, '� 3i f ti. '�► 14• t• '•- >• � ' _ •.! z-"• rc. v:••;': r MI n).+•ur ice' .,. _ ._.._.. t• ter it+ :-,i: - ��- ,�...r t •rt,r�td= . )ate yi i' � a.,),-�M. �, ___. ,., r y. ).��tr!'1S t .-_� [.. (C•J:..._..ii .. --7 0. �•- � .! t r.1 ■ T _-, .�. -.. : Ili tF`c, nom. n-_ .. ._. � _�'.... •-.■ ra,,..•., t. !1! I/1 i f,f) if�l :•■ t.. a aa.cri ° .• .moi � "� • t .�■ . s • i MW FT El t - Mv xr xFITs c -44 - ,. ... i czttlgmPMMmi-111,❑ 11YEIVITULer.-Til G1 DD _.iir..iw yy.•....r■'l 1� t i.:i.....[r• y.�i=:.... •• fr. - _ ' ! f �1 -+ K m MIMM f � _ JUW- i ti'l,I H . `E r TE AC R®® CERTIFICATEOF LIABILITY ITY INSURANCE DA`64� r Oa/2$z01 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to 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). PRODUCER CONTACT NAME- PHONE F Automatic Data Processing Insurance Agency,Inc. A/c No Exti. A/c No): 1 Adp Boulevard ADDRESS: Roseland,NJ 07068 INSURER(S)AFFORDING COVERAGE NAIL 8 INSURERA: NorGUARD Insurance Company 31470 INSURED INSURER 6 POLAR BEAR INSULATION CO INC INSURER C: PO BOX 958 Andover,MA 01810 INSURER 0: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 338194 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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. N TYPEOFINSURANCE POLICY EFF POLIO P LIMITS LTR INSD WVD POLICY NUMBER MMIDD MM/DDIYYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S DAMAGE TO REN CLAIMS-MADE F]OCCUR It:D PREMISES Ea occurrence $ MED EXP(Any one person) S _ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JET F-1LOCPRODUCTS-COMP/OP AGG S OTHER: $ AUTOMOBILE LIABILITY (CEO,M. ccidBINEent SIN LE LI T $ _ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per.cadent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR Id CLAIMS-MADE AGGREGATE $ DED I I RETENTIONS S WORKERS COMPENSATION �( PER OTH. YIN AND EMPLOYERS'LIABILITY STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 1,000,000 A OFFICER/MEMBER EXCLUDED? N/A N POWC660990 01/01/2015 01/01/2016 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE 1,000,000 S If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CONSERVATION SERVICE GROUP5 ACCORDANCE WITH THE POLICY PROVISIONS. 50 WASHINGTON STREET Westborough,MA 01581 AUTHORIZED REPRESENTATIVE A©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD irs d usmess Regulation Office of Consumer Suite 5170 x park plaza Boston,Massachusetts 02116 improvement Contractor Registration Home Imp Registration: 102726 Type: DBA Tr# 252249 Expiration: 7/212016 POLAR BEAR INSULATION CO. - Vincent LeBlanc P.O. BOX 958 ___ -------- change- ANDOVER, MA 01810 `ppdate Address and return card.p�oyrnent reason rLost Card ii Address D Renewal j ppS-CA1 E'a 5OM-04104-GlOI216 Massachusetts ..'�)epartrneM of pubi�c Safety L^cense; C,SL-106017 PETER A LEBWC 2 EAST PINE STREET Plaistow NH 038CS ' -"� 04/2812018