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HomeMy WebLinkAboutBuilding Permit # 9/29/2015 t%oRT11 BUILDING PERMIT of b �� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION '' A IL , .p eoc,.ic�e°v�c Permit No#: Date ReceivedED Date Issued. rlWm �S IMPORTANT: Applicant must complete all items on this page LOCATION04 ,M Print PROPERTY OWNER a"I „ ..„, Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village y 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 ff, /. e/. / i / /, i t�%r �W/.ci..0/, �/". . G ,/ifuJ,r 4..II(r�r0////,r/,fi��1❑".�rwr,,Ii,,St...,,rl��e'"u�,'I�JpIh�%d"Ye.�Nt,Ja./�il�c��'t�.i�'r�/»�fl�i❑a��r,rrr�,r�,W„�'�,�rr,e�v,/�J.�.r/l�l.f/ly/,�r/�/,,r,/d,�,/lr✓�//I,/r//�1!,✓r�✓,//,//�ri;��„,/l/l r�/r!//or,r/,l>�'��",,/l�,�//l/�//,Gr,,,y„>r,,f,i�r/rrl�,1A/,,,,>�,!ry/r. .,,„,CrG ri r/!r,i,F%,`li�o,.t/.,/.%.r1or,��1�1/,d l.;rT,�„p,,�,rC,,i,I�/i.i�Ir/',./_ri./�,_n/%r/r�/�/�,,//��,��,�/�,�.r,�JT�//�1/r��,„/,,.❑„�.x/��/.„/,�,,i�W,,t rp�/1l�y'le�,,tlJ%l/la>-,,//,n,�.,/i/lJd,,�d'�s,�.,'v-,%/../���,/,��'-r,r�!F,,�r1 I,;,.:WIN k%/ er ,e�,;///0cff Mill 111 DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name:” ' `I " , ' Phone: Address: � � �, l k,-, .� Contractor Name, '” Phone: Email: Address:ZI a Iz , ,� i Supervisor's Construction License: J" Exp. Date: Home Improvement License: ° `I Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST B SED ON$925.00 PER S.F. Total Project Cost: $ � l FEE: $ Check No.: � cad 3 /� Receipt Na.: NOTE: Persons contracting with unreg` ed contractors do not have access to the ra and ner �T tgORTH UWM1'%1 ofAnd(r)"" vie"b' r - E. ...'.I,. ® *19 211 In Z y o 4LAKE h Vel', Mass, • coc"Ic HFwicK �� AORAYE® � u BOARD OF HEALTH Food/Kitchen PEr% NT T LD Septic System THIS CERTIFIES THAT ,,,,, i% ,, , , ,, , BUILDING INSPECTOR ................. .............................. ..... ........... a pow . .' ems/ Foundation has permission to erect .......................... buildings on ..... .. ... ............ Rough tobe occupied as .............. . ........ .... ....... .... 1 ......... ................................... chimney provided that the person accepting this permit shall very 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 PERMITIMONTHS ELECTRICAL INSPECTOR UNLESSTI STARTS 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 Approvedthe Building Inspector. Burner Street No. Smoke Det. ( On""' n e,x t s It e p 01 vin g�,,,, This agreement to made by and amongNext Step Living,Inc.("NSL") 21 Drydock Avenue,2nd floor Roan Peeucci Boston,MA 02210 415 Salem St At phone: (866)867.8729 North Andover, MA 01845 Ue 01 4226118 25-Aug-15 1, C7E CRIf�TtrJN QF CIt�K�' BE pE1�FClRMEC1 onal manner and in accordance with the tons of this Contract, tdSL will perform or cause to ba parformork oorder describing flys worktin detail(the"Work"')awhich are finayirporated herein by reference,Pricing ratiactsd baitwv may be including the attached racommendatic subject to adjustments in program pndng and affadnga and is guaranteed for30 days from the date the Contract is printed.. COla.r�i Locatiom Attic Flat _... ... ......, _.. ... . _,_._ 12 $85.00 Hr $1,020.00 Perform Air Seating at Estimated 62.5 CFM50 Per HourMmiffisin ii i;11!1 . . Vtfor I two nt Attic Flat ____... . _. .._.... _ _._.._..._..___ 2 $50.00 Each $100,0 Replace Bath Fan Hose 1 $237,65 Each $237.6 Attic Stair Cover Thermal Barrier with Carpentry 1 $60,00 Each $W00 Hatch:Thermal Barrier Polyiso 2 inch(Attic) 94 $2.0Left $18 .70 Cramming 141 $2.00 Each $282,00 Propavent 2'or 4' Attic Floor Open Blow Cellulose$S" 1,672 $1.21 $2,02 .12 soft om 100%A sealing Incentive up to Pro'ram MSIX $1;020,00 7 %We th ri ation incentive tap to ProgrOmi MSX MENNEM stirs aced Annual Energy Savings>frorn the Above,'Crn roviamer(t 2, 08yNENL CUSTOMER agrees to pay NSL for the Work as follows 1 Payment 1: $100.00 A non-refundable 100.t by credit card(Mitstercard,Visa,or Discover card)is due at the time the Work is scheduled r Required payment information will be colle�f.at the time of scheduling.Deposit is not to exceed 113 of the total contract cost;, Additional Payments and Final invoice: $795,47 -Additional payments for the Work shall be due upon completion of the Work and will ba charges!to;the credit cord on file within 24 hours"of delivery et"the kin't Ir'I Nf this credit rd charge is declined for any reason,upon notice from N L you will be responsible for providing valid aatemetive credit rd`ird(irr dblt" r!i payment ly uata a 0 o r'6 � NSL Bigrtatrtre %/!,'✓// ,� �,''�%D�/ '/���/ / �� � G�� 'k A+��"n'e ,1~-ttrydou o/d,fIoor 1',l / l 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 MassachusefLs 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,Tera Payk Plaza,Suite 5170,Boston,MA 02116.697973=6700. 5. PERMITS NSL will be responsible for obtaining any necessary permits as the Customers 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 riom 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 teach 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,tiae Agreement may be terminated by either party. 7. INSURANCE AND REGISTRATION NSL represents and warrants to the Customer that it has a valid Horne 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. 6. QUALITY OF WORK. NSL agrees that the Worl<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 tine home due to pre-axisting 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 resenies 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 tie home itself. NSL will not be responsible for damages to or losses of any of the above mentioned property not property 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 nofiGe 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 zgrcernent 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 supersedeas=add prior agreements belvieen the Customer and Contractor and may not be altered absent a subsequent avritten agrcamcnt signed by born parties. 11. ENERGY BENEFITS. The Sponsoring Utility Company(tine Utility)is entitled to'100%of the energy benefits associated livi0a 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 conseniaiion device to perform as-xpecicd, 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{-forme 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 runction,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 rids Contract are subject to change in accordance+with The Sponsoring Utility Company Mass Save Home Energy Services Program offers. 94. CXaNITRACT CANCELLATION Under Massarnusetts tory,you may cancet this arlreerraorat if it has beery sitgraeci by a roauty t4aer to ai a;dace mthertlaan gra aatarlr7ss�v"grad setter, tyhich may`see his main office or a bunch thereof,provided you baotf ry rho setter in eyrifinf4 Eat his retain ofirce or braaa9; Planview Diagram Customer ul 11),45 c, CG I Advisor Name: Address ') 1-5 ' Ie--� S �e Advisor Phone : C1l C Town � Any limitations to access by truck? site I® NOTES Any work scoped outside of Best Practices? Approved by: T AA f�J D7 r P 20 C2) s �F The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations a d I Congress Street, Suite 100 Boston, MA 02114-2017 ivivwxiass.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.W I am a employer with 850 4. E] I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. n New construction 2.[:1 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 workingfor me in an capacity. employees and have workers' Y P tY• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. n We are a corporation and its 10. Electrical repairs or additions 3.❑ I 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 no Insulation employees. [No workers' 13.9 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. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not tho3e ontities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant on employer that isproviding 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.#: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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cover�e v fi tion. I do hereby certify under the pains and en fes perjury that the information provided above is true and correct: Si ature: Date: 1. 0/ 1 Phone#:(&dD)& Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: NEXTS-1 OP ID:EL CERTIFICATE OF LIABILITY INSURANCE DATE 112 0 1'Y) 10/01/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONI-Y AND CONFER$ NO RIGHT4 UPON TH9 G9RTIIr1QATP HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR A(.TER THE COVERAGE AFFORDED BY THE POLICIES SE4pV1f. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AuTHO)il= REP PSENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. (Iy1P RTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION 14 YV91Y� :>Id S#bg the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to MR certificate holder in lieu of such endorsement(s). CONTACT Erin Lyons PRODUCER NAME: y McLaughlin Insurance Agency aQNNe E 781.665.2775 ac No):781-665.02 826 Lynn fells Parkway E-MAIL Melrose,MA 02176 ADDRESS: John E.McLaughlin.Jr. INSURER(S)AFFORDING COVERAGE NAIL# INSURER A;Nautilus Insurance INSURED Next Step I iving,Inc. INSURER B:Commerce Insurance Company 347$ 21 Drydock Avenue,2nd Floor INSURERC:A.I.M.Mutual Insurance Co. Boston, MA 02210 INsuRERD: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 PERM INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICF�T 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. INS D L R POL CY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCEPOLICY NUMBER MMIDD MMIDD A �( COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 occuR EfrP2010198-12 09/30/2014 09/30/2015 D GE o RE TED 0,000 CLAIMS-MADE PREMISES Ea occurrence $ 1Q MED EXP(Any one person) $ CPO() PERSONAL&ADV INJURY $ 1, ,9 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ;r,QAQIAA POLICY El PRO- LOC PRODUCTS-COMP/OPAGG $ �,QAQ,QPA OTHER: COMBINED SINGLE LIMIT Ea accident $ 1,000,09 AUTOMOBILE LIABILITY ) B ANY AUTO 14MMBGKKDM 09130/2014 09/30/2015 BODILY INJURY(Per person) $ 120N$ SCHEDULED BODILY INJURY(Per accident) $ AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident X AUTOS $ X OCCUR EACH OCCURRENCE $ 5,000 00 DCLAIMS-MADE EI U783547012014 0913012014 09/30/2015 AGGREGATE $ §1009.090 TION$ PER OTH WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY Y/N TO BE ISSUED BY CARRIER 09/30/2014 09/30/2015 E.L.EACH ACCIDENT $ 500,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE ❑NIA A OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEd$ 500,00 (Mandatory In NH) If yes,descr be under E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I 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 ARARR W(((J l� Aogo,are F9gj teC� ?p',$.f ACORR '' �, � ' "7 ° a�1 3, C)ffice ® C®nsun7er Affai and business i;Vgue n 10 Parr Plaza e Suite 170 Boston, Massachusetts 02116 Kerne Improvement Contract®r Registrati®n 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 E] Employment Lost Card DPG,.CAI wa VSf'IGv9 C?d�Y"Y..t;';;t/f1/1:a1fi1 / p' Office of Consumer Affairs&Business Regulation License or registration valid for individul use only r w ;'IiOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: office of Consumer Affairs and Business Regulation Registration: 162111 Type: -q517010 Park Plaza-Sm ... �arr ,. Expiration:: 1/14/2017 Supplement Card Boston,MA 021 i/'k' NEXT STEP LIVINGINC, ROGER OUELLETTE ' -- 21 DRYDOCK AVE.2TN FL BOSTON,MA 02210 Undersecretary ,t?tyvalid without signature Massactiusetts DepaOrrwnt ot (,:Iub kc Satel�y u,d r)f: B�Wdmg RegLflafions <,inrj Stardards onitruction Ii'upi r% kor Spvc ,�,Ifl('% � i e ns e, CSSL-1 02,811 ROGER A LLET 55 STANMORE Wandek RI 02899 E,x p I at -w C 091IN2016 RestFicted To: CSSL-lC-Qnsulation Contractor Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS