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HomeMy WebLinkAboutBuilding Permit # 9/23/2015 IAORTH BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION y® ' A T - M Permit iV®#° Date Received 0S ATEO CHUs Date Issued: 'r e IMPORTANT:Applicant must complete all items on this page LOCATION ROPERTY OWNER St'0— TO-N l- b U\'eC6) Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District ye no Machine Shop Village ye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition [I Two or more family 11 Industrial ❑Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other y ff m, a, ru✓r,�1, k �r/r �i//,l r /�(/ ,li I,,. %� ! r/ r ! ,.,,,erl :i / /i,�„r,/, a !'J/!//�,�,� r 1 ,»r - /❑Wetlands.r , ,� ❑ Wat, ,.,,� � � I/r , �� h� ,� ells /./�, , ,1/ f �, ❑ Flood n � „y,, ,,, �, „n / �/� //I Sertfc Nl.❑.W � /r%/ tip!,/, Yf , ,,,, �,r, o�,.,,, ,, „ /. � <, � Jr , � /Ji, �� DESCRIPTION OF WORK TO BE PERFORMED: �TM Idem% Location OWNER: Name' ' °` No Date TOWN OF NORTH ANDOVER Contractor Name: ,i�, rail Email: Address: Certificate of Occupancy $ Building/Frame Permit Fee $ Supervisor's Construction Lice Foundation Permit Fee $ Other Permit Fee $ Home Improvement Licenser TOTAL $ ARCHITECT/ENGINEER Address: check )C ` 6Z—", r FEE SCHEDULE:BULDING PERMIT:$I Building Inspector Total Project Cost: $ Check No.: � O a 30Receipt No.: .c NOTE: Persons contracting with i contractors do not have access to the ca unci !' ., r'ff_1 A" t%cMTH -uver 74" vL i own of No. ver, Mass, COCMIC"t WICK 1_ Q�RATED 11 BOARD OF HEALTH PE �Rmm� IT L) Food/Kitchen Septic System THIS CERTIFIES THAT ........ � / BUILDING INSPECTOR . .. .�Jy SQL Foundation has permission to erect .......................... buildings on .. `. —'.... ....................................................... p Rough �. =i✓ScJ/,-�",0-" tobe occupied as .............. r:.l.:.. .z................................................................................... Chimney provided that the person accepting this permit sh�11 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 Rough VIOLATION of the Zoning or Building Regulations voids this Permit. Final PERMITI IN 6 MONTHS ELECTRICAL INSPECTOR LES T T Rough ............. ...... . Service :.................................. Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permiteguired to Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final o Lathingor all To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. f"1 next step Living, home energy solutions This agreement is made by and among Next Step Living, Inc.("NSL") Stefanie Johanson 21 Drydock Avenue,2nd floor 453 Johnson St Boston,MA 02210 phone: (866)867-8729 North Andover, MA 01845 Site ID: A886650 09-Mar-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: !Description SealingAir Recommendations $851 11 Work Location. Attic Flat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 10 $85.00 Hr $850.00 Weatherization Recommendationsi 1 •1 Work Location: Attic Flat Hatch:Thermal Barrier Polyiso 2 inch(Attic) 1 $60.00 Each $60.00 Dammii� - 12 - 25 1 nit - $24 60 'Propavent 2'or 4' 74 $2.00 Each $148.00 Atttloar Qpenlow Celftalose{11":- Wdrkl.oeatLdh Fountratton Im � � s Insulate Rim Joist with 6.25"Fiberglass Batting 115 $1.75 Lnft $201.25 Initial Investment: $2,680.6.0 - F 00%Alrseairng�ncentr�e up�o_program Max--� $$5�00 �-�� ' `Y5 d/o UVea�harizatioli lncer�tlu� up to4Prograrn Max $1372 95 Estlma�ed Annual Ent?rgy Sa�ingefrom�he Above-lmpro�ements �$552�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 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 113 of the total retail costs. (Note:Mastercard,Visa,and Discover accepted) Additional Payments and Final Invoice:' $357.65 -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 u are paying by check and your card will not be charged unless we fail to receive payment within 5 days of invoice. i custornef Si nature date _ 9 Mar 2015 Andrew Carpentier NSL Signature Date Name of NSL Representative A886650 The Terms of this Agreement are contained on both sides of this page Next Step Living.21 Drydock Avenue o 2nd floor.Boston,MA Q2210"(866)867-8729.inquiry@nextsteplivinginc.com o www.nextstepliving.com TERMS OF AGREEMENT A886650 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,Sulte 5170,Boston,MA 02116.617.973.8700. 5.PERMITS NSL will obtain 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.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 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. 6A 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. 7.NSURANCE 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(1),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 COND1fIONS&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 remedlation 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 eROV1866. 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 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. You may cancel this Agreement If it has been 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 delivery,not later than midnight of the third business day following the signing of this Agreement. Seethe attached notice of cancellation form for an explanation of this right. 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: 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 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. 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 Customers 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 it has been signed by a polViiersto 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 or by delivery,not later than midnight of the third business day following the signing of this agreement. Plainview Diagram customer 4 ate, aAdvisor Name: Cdr e.,, ke— Address �1 T3 �o tin s0-1 fd, Advisor Phone #: Q�7 2 — �8gs—s�os' Town AM Anel o ver- Any limitations to access by truck? Site ID fA-9 9 126 `S O NO NOTES Any work scoped outside of Best Practices? Approved by: ®.� RAJ `� �` 3 t 5I ,CI) 37 O � vaK1fi e.i IrtuS G�4 � � z� Av l:/ y 37 The Commonwealth ofMassachaseffs Departmew of IndustriW',4cridengs Oft-ice of In vesdgadons Congress Streei, Sufte 100 Boston, HA 02114-2017 wmw.ma&g�.gols�,fi*a Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Apacant Information plpaep print Name (Busiricr./Organi�ationUdividual): Next Step Living Address: 21 DrydockAve C ity/Statel p:_Boston, MA 02210 phone#:(866)867-8729_Zi _ Are you an employer? Check the appropriate box-, Type of project(required): I am a employer with 860 4. [] I am a general contractor and 1 6. n New construction employees (full and/or part-time).* have hired the sub-contractors 10 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' 9. E] Buil&ag addition [No workers' comp. insurance comp. insurance't required.] 5. EJ We are a corporation and its 10.El Electrical repairs or additions 3.0 1 am a homeowner doing all work officers have exercised their 111,E]Plumbirtg repairs or additions myself [No workers' comp. right of exemption per MGL 12.n Roof repairs insurance required.] t c. 152, §1(4) and we have no Insulation employees. [.No workers' 13.X Other comp. insurance required.] *Any applicant that checks box 01 must also fill out the section below showing their workers'compensation policy information. I lomeowners whe submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidal-it indicating such. xCoatractors tthai clieck this box miist attached an additional sheet showing the name of the sub-contractors and state whether or rot th030 Ontitim, have employees. If the sub-contractors have employees,they must provide their workers'comp.policy mjtnber. I am an e;;P,=I—oyer that is providing workers'comp ensadoninsuranceformyemployee& Below is the policy and job 3fte A.I.M Mutual Insurance Company Insurance Company Name: Policy A or Self-ins. Lic.#: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 WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA fbi insurance coverafie y0flotion. 1 I do hereby certify under the pains andpenllles 1,111periu,y that the information provided above is true and correct. Phone U P_idQ) 1.[Oficial,ricial use only. Do not write in this area,to be completed by co or town qfflciaL City or Town- Permit/License# f a'use' City or Tow Issuing Authority((circle one): Board of Health 2.Building Department 3.City/Tower Clerk 4.Electrical inspector 5.Plumbing Inspector 6.Other Contact Per ontact Person: Phone S.— WEXTa_li OP 10:EL CERTIFICATE OF LIABILITY INSURANCE 10101/200 14 THIS CERTIFICATE IS ISSUED AS A mATTEP, OF INFORMA71 RON 0%y AND CONFERS NQRIQHTq VVION THV RRTIFIGATP HOLDER.THIS CERTIFICATE DOES HOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR, AR C-R THE COVERAGE AFFORDED BY THE POLICIES BELQW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTPUACT BETWEEN THE ISSUING INSURER($), AUTMORIMP RSP I �SEHTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, 111017 RTANT: if the qeMficata holder is an ADDITIONAL INSURED,the pollcy(les)m",q-k he endorsed. If SUBROGATION Iq WANED,qg0jagg tq the terms @nd conditions of the policy,certain pollMeo may vegulve ml(""dorsenient, A statement oil tills cefifflGate-does not cofiie�wights t® —certificate holder in lieu of such end-oreemeriffs). _..CONTACT PRODUCER NAME: F-An Lyons All M�LaLlghil PHONE..,,,,,70-665-2775 AIC.No): to_ n Fel Es ParkWpy (A IN I F 1328 Lyn Melrose MA Q-1176 E-MAIL John E. I McLaughlin Jr. E-MAIL INSURERS)AFFORDING COVERAGE NAIL if wsuRrr A;P1,gigAillus Insurance INSURED �J@A Step�Wlna,1111C. IMSUPEP 0:Gammpwce Insurance compaily 21 Drydock Avenue,2nd Floov IMSupEp c:A.I.M.Mutual Instirance Co. Bostan,MA 02210 INSURER D:hVIS Insurance Company 15610 INSURER E*. INSURER r: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER- TH'IS IS TO'CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 10 THE INSURED NAMED ABOVE FOR THE POLICY gRO INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT-10 WHICH T Is CERTIFICA,T E MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E)(CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR 4DOL SUER POLICY EFF POLICY EXP LTR TYPE OF INSjJRAMCE anWVPOLICVNUMBEP MMIODP OTA-102= LIMITS A X COMMERCIAL GENEIZALLIABILITY EACH OCCURRENCE __Mm CLAIMS-MADE FRI OCCUR PREMMjGsEES`(0E!E TuEfD a occ rence) MED EXP(Any one person) PEPSONAL.ADV INJURY 8 GEM'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY F�JECTT FILOC PRODUCTS-COMPIOP AGG $ POLICY $ OTHER:: CdFABINE I GLELIMIT S AUTOMOBILE LQAGIIATV (Ea accident) ANY AUTO 09130f20-1 5 130DILY INJURY(Per person) ALL OWNEDSCHEDULED BODILY INJURY(Pei accident) AUTO., x NON-OWNED (PROPcE.R DAMAGE AUTOS Per. Q HIRED AUTOS id ) E; —L'o-L, —CCCL., F-ACH OCCURRENCE EXCESS RETENTIONS LIAB CLAINIS-MADE AGGREGATE $ DIED RET ENTION 5; —k— STATUTE PUFOTHWORKERS COMPENSATION SEAR T T TE AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORtPARTNERIE),ECUTIVE MIA TO BE ISSUED BY CARRIER 09/301,2014 OP/30/2015 E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? El (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ if es,desonbeunder 30I�0®11 T DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Rernar'4s Schedule,may be allechod 11 more space is required) rOR INEFORMATION ONLY CERTIFICATE(HOLDER CANCELLATION IMFO-01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Foir lilforrPhatlop oply ACCORDANCE WITH THE POLWY PRUAASIOMG. AUTHORIZED REPRESENTATIVE Alp— CORPOPIATlCK ILII 1°flats 1°eSeU err, VW wo onq lRoaz w')m4fth7i VNI"' 'v4p'V ACORR,' i office' of Consumer Affai��� and B������� Regulation 10 Farre Plaza o Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 162111 T Vpo: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 ®RY®®CK AVE. 2 E H FL BOSTON, MA 02210 Update Address and return card.Hark reason ffDr change- M Address E] Renewal [] Employment E] Lost Card 10" r(., office of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. If sound return to- HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration: 162111 Type: 10 Park Plaza-Suite 517D Expiration: 1114122017 �;uppfernenl Card Boston,1AA D21 k6 NEXT STEP LIVING INC. POGER OUELLETTI" 21 DRYDOCK AVE.2TN FL � � - BOGTONf MA 02210 (U¢a¢derseere a�°g INot valid arliti ouCcc signature L 0 C140,rW,�,'Ujo iujpc'#"', vor crft,, t v,flo, 11 — : CSSL402811 dna OGE,R A OVELLIET 55 STARMORE, WnMck IN NOW 09§132018 Reaivicted TO: CSSL-OC-WuNlion Contractor t Failure to possess a current edition cO the UWassachusetts State Building Code is c�use for revocat,bn coOthis license.