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HomeMy WebLinkAboutBuilding Permit # 9/29/2015 BUILDING PIT �y Fp- O�KKED�„ ;6�•Y� �� ��.`�t(- 'x_•11 6 TOWN OF NORTH ANDOVER ® APPLICATION FOR PLAN EXAMINATION ` A may_ Permit No#: Y� Date Received /�p�RgTED cHus�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION Az ct)o o:1,r Print PROPERTY OWNER ( ,I � � MAP(P� ""' I � (,PARCEL: ZONING DISTRICT:Print 100 Year Structure yes no Historic District yes no Machine Shop Village 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 --.rr � ,,, e =r �, r /U /a J ✓/r./ ,� v. .d„r..rr .., r/,r. ,J/r P� ! Jr it r. lr ry �ml ,..r / a--,r ,i ii ./ r/ �/✓l/�iy.r,G..r„Gil 1 /,. !r r ,.. ,/ �„ l , /,ci✓f. e. if,., h f�rlr r,r rllr .i i.! „/ 6 /e.� //,l�,.. r„/r 1,: G, .!. /„r;.,/ „u � r �r r�i ,,� r< „/,ire/✓//i, // r rJ„✓ /r ri !1, r ry � /, ./ V 1, ,, r „ r�r/,// i] �k'G, ��/ l I 0/, /,/r, c If✓�%,, ;, ! r lrrr ., ,,� �, /rrrl yr LIr rr L /, . ,,, r 1 0 ,,r, ill/ ,1%/, //rr r rt /r y r rl /i„r, �// / ✓/,� � u c ,/�r, (,,,,,,� /�r ,r ✓1�,/,///JI, ��r /� ., l�a, < , �r r% /,, ,r //�i // � � GC � S IC /, � o r,, ,, ,� , , ,,. r ,, , r��, , , ,//, i,, . Gy,,c , � /, ,�r, , ,etlands, /,� �l, r ❑rrrWatershed Di fr � 7r��., �,,, , ,�, f�,, ,f ❑,Flood lain �/>' D W f r��/� .r , , , l / , U rJe ,tIC ❑Well/r r /�fi//� // i, 1 /i' r 1�� /r Y f r G, it �f, �i ��, �, p „r , �//,�„ >tr, /,J ,,uri,r ,1?r,.,, r, / r� ��„ i. 10 ✓y � f,,-„- i �i V1rli da���/�J”, r r/- W�fe,��nS,ewetr����/���rr'r�y �����/�>��/��,/�i,U/� ,�rla�ir<� �1� ������ >,1�>�,.��, DESCRIPTION OF WORK TO BE PERFORMED: �1, � ' ) Identification- Please Type or Print Clearly OWNER: Name: � .ol � ” Phone: Address: JCJ 41121,k ,r ... .. a ” LIX Contractor Name Phone: Email: Address: .. �.. , Supervisor's Construction License: . Exp. Date: 24,-�&/l Home Improvement License: Exp. Date: I ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ eaNt FEE: $ 1 I Check No.: Receipt No.: ” MOTE: Persons contracting with unregiste contractors do not have access to the guaran and j r tk®RT#j Uwn of Anduver 0 • - - O LANE vary ass' COCAZO NIC NE WICK U BOARD OF HEALTH Food/Kitchen PERMIT 1 "l LD Septic System THIS CERTIFIES THAT „�S, l ...........................................THIS INSPECTOR Foundation has permission to erect .......................... buildings on .... ...........i" ..0'r .....1[::w.............. Rough to be occupied as ..... .... ..� ............... Chimney .... .......... .... ... ..... ®................. provided that the person accepting this perm) shall 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 PERMITI IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS I T S Rough Service ............. .E...E..................................................... 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 Approvedy the Building Inspector. Burner Street No. Smoke Det. next step living. home energy solutions This agreement is made by and among Next Step Living, Inc.("NSL") Kyle Olson 21 Drydock Avenue,2nd floor 19 Kara Dr Boston,MA 02210 North Andover, MA 01845 phone: (866)867-8729 Site ID: 423101 26-Aug-15 1. DESCRIPTION OF WORK TO BE PERFORMED NSL will perform or cause to be performed the following work on the customers address above,In a professional manner and in accordance with the terms of this Contract, Including the attached reoommendations/work order describing the work in detail(the'WoW)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.. b6scription Quantity 'Air Sealing Recommendations : 111 Work Location: Attic Flat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 10 $85.00 Hr $850.00 Weatherization Recommendations $2,561.62 Work Location: Attic Flat Attic Stair Cover Thermal Barrier with Carpentry 1 $237.65 Each $237.65 Damming 98 $2.05 Lnft $200.90 Vent bath fan to soffit exhaust 2 $118.75 Each $237.50 Propavent 2'or 4' 97 . $2.00 . Each $194.00 Attic Floor Open Blow Cellulose 5" 1,011 $1.21 sgft $1,223.31 Install 6"Fiberglass Batting In Open Attic Floor 262 $1.48 sgft $387.76 Work Location: Knee Wall Install 2"Thermal Barrier Polyiso on Kneewall 23 $3.50 sgft $80.50 Initial Investment: $3,411.62 100%Airsealing Incentive up to Program Max $850.00 75%Weatherization Incentive up to Program Max .$1,921:22 Total .� � - � Estimated Annual Energy Savings from the Above Improvements $148.00 2. AYP MENT: CUSTOMER agrees to pay NSL for the work as follows: Payment#1: $100.00 -A non-refundable Deposit by credit card(Mastercard,Visa,or Discover card)is due at the time the Work is scheduled.Required payment information will bs ooliected at the time of scheduling. Deposit is not to exceed 113 of the total contract cost.. Additional Payments and Final Invoice: $540.40 -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 the Final Invoice.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 /� /,— — 0116//r Customer Signature Date 26 Aug 2015 Andrew Carpentier NSL Signature Date Name of NSL Representative A1254059 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 0(866)867-8729.inquiry@nextsteplivinginc.com.www.nextstepliving.com TERMS OF AGREEMENT 423101 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 Directorof 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 02116.617.9738700. 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 times,our weatherizatlon 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 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 NSUs 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 drywail,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 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 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 It has been signed by I 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 Emer 2%�.(P ��SeAdvisor Name: ss _ ! lru 11C Advisor Phone #: Town Any limitations to access by truck? Site ID � Z3 io.l NO NOTES Any work scoped outside of Best Practices? Approved by: U h/'5 41SZ L- 5 76 I- i)a nc,— " V0 l Slope,-- yi3o 2317 y Je,j4-bR 14D S9> 't 2,, AIS P(o�� PYW pave- q 7 tI i7 gs� i C)U ,� �3 39 PAS S i 2 z6 z� P O I O f e �- S 5 �e,� The Conninonwealth of Massachusetts Department of Industrial Accidents W Oce of Investigations d I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly NarT10 (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): 1.n I am a employer with 850 4. F� I am a general contractor and 1 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 sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 E]Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. E] We are a corporation and its 10.0 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.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no Insulation employees. [No workers' 13.Q Other _ comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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 those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant 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. Lic. #:'SWC-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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cover ge vedii tion. Ido hereby certify under the pains and en fres perjury that the information provided above is true and correct Signature:. Date: C� / Phone#•(&W4 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License.# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: NEXTS-1 OP ID:EL ��® CERTIFICATE OF LIABILITY INSURANCE DATE 1/2 0 1 Y) 10/01/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON4-Y AND CQNFER$ NO RIGHTS UPON TH9 G911TIFIQW HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AI-TER. THE COVERAGE AFFORDED BY THE POLICIES 13ELQVy. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), 4PTHORIz p RPP FSENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the gertificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WIY�9,SBkLSfj the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to 4hp certificate holder in lieu of such endorsement(s). co"TA PRODUCER CT Erin Lyons MgLaughlir)Insurance Agency PHMo E:d:781-y665.2775 FAX No):781-665.02 828 Lynn fells ParkWpy EMAIL Melrose,MA 02176 ADDRESS: John E.McLaughlin Jr. INSURER($)AFFORDING COVERAGE NAIL q INSURERA:Nautilus Insurance INSURED Next Step Living,Inc. INSURER B:Commerce Insurance Company 347$ 21 Drydock Avenue,2nd Floor INSURERC:A.I.M.Mutual Insurance Co. Boston,MA 02210 INSURER D: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 PER w INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH T 18 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, I S D L BR POL CY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NUMBER MMIDD MM/DD A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000000 1VIOCCUR ECP2010198-12 09/30/2014 09/3012015 A IS o RE ED 0,000 CLAIMS MADE PREMISES Ea occurrence) $ 1 Q MED EXP(Any one person) $ 0,900 PERSONAL&ADV INJURY $ I' rt ,1 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ?rQttOrQM POLICY❑PROT F LOC PRODUCTS-COMP/OPAGG $ ?IQQQ,QPQ JECOTHER: COMBINED SINGLE LIMIT AUTOMOBILELIABI{JTY Ea accident) $ 1,p0p,0p B ANY AUTO 14MMBGKKDM 09/3012014 09/30/2015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILYINJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident HIRED AUTOS X AUTOS $ UMBRELLA LIABX OCCUR EACH OCCURRENCE $ 55,000 00 D EXCESS uaB CLAIMS MADE E�L!783547012014 09/3012014 09/30/2015 AGGREGATE $ §1009109 00 $ DED RETENTION$ WORKERS COMPENSATION X STATUTE I I ERH AND EMPLOYERS'LIABILITY Y/N TO BE ISSUED BY CARRIER 09/30/2014 09/30/2015 E.L.EACH ACCIDENT $ 500,000 C ANY PROPRIETORIPARTNER/EXECUTIVE ❑N/A OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYE $ 500,00 (Mandatory In NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,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 REPRESENTTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/91) Thp ARRRp 90MR I��Q are P91!�?QCqO.f ACORN 'C Office o Consumer Affai and Buss Regulation 10 Parr Plaza e Suite 170 Boston, Massachusetts 02116 Home Improvement Contractor registration Registration: 162111 Type: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 ®RY®OCK AVE. 2TH FL BOSTON, MA 02210 Update Address and return card.Mark reason for change. Address 0 Renewal 0 Employment Lost Card OPS-CM 2", Pnryry aarc +aahwlfi u.¢' -Gr-:camx: r,5a G� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only { HOPVIE IMPROVEMENT CONTRACTOR Office the expiration date. If found return to: t Office of Consumer Affairs and business Regulation Registration: 162111 Type: 10 Park Plaza Sujt�51`/0 Expiration: 1/14/2017 Supplement Card Boston,MA 021l,6y' NEXT STEP LIVING INC ROGER OUELLETTE 21 DRYDOCK AVE.2TH FL atid without signature BOSTON,MA 02210 Undersecretary of'v Nk,issax;f''i usetls C)e�,,)artrnent of Pubhc Safety Board ot B�,JkJ�r,�g Reguhitwms and Starv:,Jards SpvciriW� CSSL-102811 ROGER A OVELLET 55 STANMORE Wgandck RI 02899 LXpf rabon 091IN2016 Restricted To: CSSWC-ffisulation Contractor Failure t®possess a current edition d*the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: wbvw.Mass.Gov/DPS