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HomeMy WebLinkAboutBuilding Permit # 9/30/2015 BUILDING PERMIT �oRr",, ®��.�,LED fa O TO OF T ANDOVER f• _" 4a 11 APPLICATION FOR PLAN EXAMINATION ® ` , Permit No#: Date Received TED �R �s�cwuse Date Issued: MPORTANT: Applicant must complete all items on this page M�. LOCATION �,,, � � ....,(SAry-,t 1 ,..� Print PROPERTY OWNER ° PARCEL. " ZOI Print 100 Year Structure yes no MAP CISTRICT: Historic District ye no - Machine Shop Village yej,' 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 ,;„ «,,...;. r,rr rr-. o ..,,.. �rr,✓r i /ri!/ r f/rl,...GlL� Jl,i.., / / / 1 I, /! ,r.. rJ r,, r ,,., / 5 : ,. r/ ,..r, /., %-r (, �D.str ct. /l >/✓moi%:: , � � /�,/ f/ �,!❑ Watershed. a � , , y,. rW , , �❑,W,etlands,•, � r, � ��A / r, ,Flood ❑, Se �i ❑t ir,�/,,%J �, /, f� J�;-,r � ,prr ,�JI /fe. /�//,r✓//�.' /1 -� �, r bl�' �If r.�� d DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name " c Phone: w� Address.A .. Contractor Name: 1. Phone: Email: l Address:2 7 Supervisor's Construction License: /1( � Exp. Date: —�� Home Improvement License: r Exp. Date: / 141 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.-$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ , " FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with ed contractors da not have access to the r zcrzd 5; - - — - Arm F ttORTH on.-Ift e r it okwn of iiduv �^�� h ver, ass, COC HICHI'W.CK �1. �®A0RAYE® g..Admak PE`�,i� S 'g �•J BOARD OF HEALTH Food/Kitchen PE M- IT TV L D Septic System THIS CERTIFIES THAT .. ... .1................ BUILDING INSPECTOR Foundation has permission to erect .......................... buildings on .... .�......:. .Ca ......... ►.. ................... Rough LA to be occupied as ................. �./ .1. ...... . . ....... ...�........�,.�,�.1�:��.�.......... Chimney provided that the person accepting this permit shall in a ry 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 A PERMIT EXPIRES IN 6 MONTH§ AELECTRICAL INSPECTOR ® UNLESS CONSTRUCTI TA Rough Service ..................... ... ....... ........................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Buildin Rough Displayin a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. Living,next step hours energy solutions This agreement is made by and among Next Step Living, Inc.("NSL") Heidi Connelly 21 Drydock Avenue,2nd floor 481 REA ST Boston,MA 02210 NORTH ANDOVER, MA 01845 phone: (866)867-8729 Site ID: 423222 03-Sep-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 recommendaiionslwork order describing the work in detail(the'Woq')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.. Work Location: Attic Flat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 12 $85.00 Hr $1,020.00 AM ® �- • Work Location: Attic Flat Hatch:Thermal Barrier Polyiso 2 inch(Attic) 1 $60.00 Each $60.00 Vent bath fan to roof flapper 3 $118.75 Each $356.25 F Pj opfiVfrCit 2` Attic Floor Open Blow Cellulose 5" 418 $1.21 sgft $505.78 Work=1=bcatiort knee Wail t l A r Install 2"Thermal Barrier Polyiso on Kneewall 23 $3.50 I sgft $80.50 Kneewall Floor Open Blow Cellulose 7" 115 $1.24 sgft $142,60 Work Location: Garage Dense Pack 10"Cellulose In Garage Ceiling 668 $2.07 sgft $1,382.76 'WprkLoc�tipn' Mis4 ° Temporary Access 1 $85.00 Each $85.00 :9 r , x 5 t add%Atrse�liftg lnc�ti#ive����P�o�t•�tn lax ;$�,�24 OQ' We �hriz�#io ..111Gf1#ive t�pxo Program ix $ dOQ OQ Ail r . z #irraadAhnua! fiet� Sayings frttT►fhetAt� �, . p,,. .. .., .p X26 00 r Q e lm Ibvatnerj# , r 3 Cts, aSir, Customer Signature Date 3 Sep 2015 Edward Yaracz NSL Signature Date Name of NSL Representative A1257103 The Terms of this Agreement are contained on both sides of this page Next Step Living 21 Drydock Avenue 2nd floor o Boston,MA 02210 0(866)867-8729 o inquiry@nextsteplivinginc.com a www.nextstealivine.com TERMS OF AGREEMENT 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,Suite 5170,Boston,MA 02116.617.973.8700. 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,NSL's 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 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 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 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 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 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 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 Conservation Services Group(CSG)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 CSG,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 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 e-mail sent or by delivery,not later than midnight of the third business day following the signing of this agreement. Planview Diagram Customer_ ��J� a�,,,11.. Advisor Name;_ aLdi Ya�rz. Address �-}�1 (fie,, 5� Advisor Phone #: 15') Town �� /A��pVec Any limitations to access by truck? Site ID �/vo— NOTES Any work scoped outside of Best Practices? (i Apgrov6 � y.✓ `� Poly K�� r�•5 23 A/S '' i 11 qti i c WF- +I � / Poky r fes✓ Q� i 9011 K\,J V '� v�. fit' }p ��' �✓ � fia` APGe i� f����e C�;1��-� ��� - P o8(A3 HI n2z. �leor � Z3 1 i1, r ro, SLOPE 3 P 1'L t:.W -------------- 6 o� t4ou5e- The Comi=nonwealth of Massachusetts Department of IndustrialAccidents 60 W Office of Investigations d 1 Congress Street, Suite 100 Boston, MA 02114-2017 wwm mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (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. I am a employer with 850 4. E] I am a general contractor and 1 6. 0 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. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. [] We are a corporation and its 10.n Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 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 noInsulation employees. [No workers' 13.0 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 isproviding workers'compensation insurance for fny employees. Below is the policy and job site information. Insurance Company Name: A.I.M Mutual Insurance Company Policy#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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cover�ge v,pdfi tion. I do hereby certify under the pains and en es perjury that the information provided above is true and correct. Signature: Date: Phone#45Lda)&_7—M—a�I Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: NEXTS-1 OP ID:EL A CERTIFICATE OF LIABILITY INSURANCE DATE(M1120 YY)L 4 10/01/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION O%y AND CQNFERS NO RIGHTS UPON THE GTIFIQATjE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BEI,OVY. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RI:P FSENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMP RTANT: If the pertificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS}1f )�(Rt,@y 6# 9 the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEACT Erin Lyons M�Laughlin I su ance Agency PHONE 781-665.2775 ac No,:n f AIC No Ext: 781-665-02 828 Lynn fells Parkyyay E-MAIL Melrose,MA 02176 ADDRESS: John E.McLaughlin,Jr. INSURER(S)AFFORDING COVERAGE NAIL# INSURER A;Nautilus Insurance INSURED ext Step�Iving,Inc. INSURER B:Commerce Insurance Company 347$ 21 Drydock Avenue,2nd Floor INSURER CALM.Mutual Insurance Co. Boston,MA 02210 iNsuRERo: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 PERIQp 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 DD BR POLICY NUMBER MMILDDY EFF MMILDIDY EXP LIMITS LTR A X COMMERCIAL GENEFAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE X OCCUR ECP2010198-12 09/30/2014 09/30/2015 pREMSES Eaoccurt0ence $ '190,000 MED EXP(Any one person) $ 0,900 PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ �rIQ1{10�QQ POLICY❑ PELT F]LOC PRODUCTS-COMP/OP AGG $ ��QQQ,QPD OTHER: AUTOMOBILELIABI),ITY EaaccdentSINGLE LIMIT $ 1;009,09 BANY AUTO 14MMBGKKDM 09/30/2014 09/30/2015 BODILY INJURY(Per person) $ ALL OWNED y SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOSX AUTOS Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000 00 D EXCESS UAB CLAIMS-MADE E(,1.1783547012014 09/30/2014 09/30/2015 AGGREGATE $ fi,QO , 00 DED RETENTION$ $ WORKERS COMPENSATION X PER 0TH STATUTE ER AND EMPLOYERS'LIABILITY Y/N TO BE ISSUED BY CARRIER 09/30/2014 00/30/2015 E.L.EACH ACCIDENT $ _500,000 C ANY PROPRIETOR/PARTNEWEXECUTIVE N I A OFFICERIMEMBER EXCLUDED? SQO,QQ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEEI If yes,describe under E.L.DISEASE-POLICY LIMIT I$ 500,00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014191) TO 491PIRP 4MR ATO INN 4F�qI�te��� ��gf ACORR PC ® Cans - er Affair and Business Regulati®n 10 hark Plaza e Suite 5170 Boston, Massachusetts 02116 Home Improvement Contract®r Registration Registration: 162111 Type: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 DRYDOCK AVE. 2TH FL BOSTON, MA 02210 Update Address and return card.Mark reason for change. n Address F-] Renewal [j Employment F] Lost Card 4, Office of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. If found return to: a ; (HOME IMPROVEMENT CONTRACTOR p ,N Office of Consumer Affairs and Business Regulation Registration. 162111Type: 10 Part Plaza-Sujt�5190 Expiration: 1/14/2017 Supplement Card Boston,MA 021�6� NEXT STEP LIVING}NC. ROGER OUELLETTE 21 DRYDOCK AVE.2TH FLYq BOSTON,MA 02210 Undersecretary 1`tl valid without signature M as s!'U.,h u s etts De�,,)artrner�t of Pubbc S,Rfety Bc,)ard of BUdChng Reg wat�on�, and Stan(J,,Irds ROGER A OVELIATT 55 STANMORE WarMck RI 0280 J rat Restricted To: CSSwc-insujatlon Contractor Failure t®possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: tyww.mass.Goy/Dp5