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HomeMy WebLinkAboutBuilding Permit # 12/4/2015 ORTH BUILDING PERMIT %A'_E D 6 TOWN OF NORTHA VE 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received1.ArED II-' I- Date Issued: 1'14 S.V C US IMPORTANT: Applicant must complete all items on this page �� ,������� �� �,� t � ��/ r,/,, ,, / />���/G„/,� , / �� rr ( , l I, ,Vii; �;� rt ,Q � , ; .l ,r,��� � �,/� ��I�i ,�i/���,/r�����>� ������� r/,� 1,, �,'i, 1 01 .1, 11111 J"1111r, 7.........'A, 10711)7)"Fl, 1p" 71,71 rr "Di S' R/ ,15 h TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ;SOne family 5(Addition D Two or more family 11 Industrial 11 Alteration No. of units: El Commercial El Repair, replacement El Assessory Bldg 11 Others: El Demolition 0 Other DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address:y/,/ "i"MI'MR,rr IM NO" r,r rr, ................................. , rrr ',, ���, � 1 /�/ �/ e !ly', p�:�, ,4µ,i �����1 i�� �1�: 1 �3 � /��� ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ r FEE: $ Check No.: 6 Receipt No.: 0 NOTE: Persons contracting with contractors do not have access to the r and ........... 6"n'at"Li re of­'A` "8' , contractor N j qeh OWh&''' ignature'o , t%®RTH "' nclover ® . 2AI C% tw.ca 11 t ver, s�79 i f COC NIGNQ WIC. S U BOARD OF HEALTH FIX Food/Kitchen P t Septic System e BUILDING INSPECTOR THIS CERTIFIES THAT ............. ..... .. .. .. 0Mhas permission to erect buildings on .. Foundation Rough to be occupied as .... ... . ........ ..... ...... ... ....... ....6r.c.,."'... ............................... Chimney provided that the person accepting this permit s n 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 PERMITIMONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUC,Tr(ON Rough =' Service .........: .......... .... �:......,..................... 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 Lathingor Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. P next step Living, home energy solutions This agreement is made by and among Next Step Living,Inc.("NSL") M211SSa TgettlS 21 Drydock Avenue,2nd floor 10 Lancaster Rd Boston,MA 02210 North Andover, MA 01845 phone: (866)867-8729 Site ID: 425800 26-Oct-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 recommendationatwork order describing the work in detall(the`WoW)which are incorporated herein by reference.Pricing reflected below maybe subject to adjustments in program pricing and offerings and is guaranteed for 30 days from the date the Contract is printed.. oves be's6riptiAnently SealingAir Recommendations00 Work Location: Attic.Flat Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 12 $85.00 Hr $1,020.00 Weatherization Rec6mmendations Work Location: Attic Flat Damming 126 $2.05 Lnft $258.30 Vent bath fan to roof flapper 2 $118:75 Each $237:50. Propavent 2'or 4' 126 $2.00 Each $252.00 'Attic Floor Enclosed::Cellulose Dense Pack 8" .. 208 $1.80 sq ft $37440` Jnstail 9"Fiberglass Batting In Open Attic Floor 192 $1.67 sgft $320.64 Attic.Floor Open Blovv:Cellulose 10".;. 1;146 so $1,684:62 Work Location: . Misc Sheathing Access 2 $31.31 Each $62.62 Work Location: Doors Door:Thermal Barrier Polyiso 2"(Attic) 1 $73.91 Each $73.91 Initial Investment: •. 100%Airsealing Incentive up to Program Max $1,020x10 .75'.%Weatherization Incentive tip to Program Max $2,000:00 Total . . Estimated Annual Energy Savings from the Above Improvements $476:00 16 Customer Sign1&atu Dat 26 Oct 2015 Elizabeth Venuti NSL Signature Date Name of NSL Representative Al 301820' The Terms of this Agreement are contained on both sides of this page Next Step Living.21 Drydock Avenue-2nd floor^Boston,MA 02210.(866)867-8729.Inquiry@nextsteplivinginc.com o www.nextstepliving.com TERMS OF AGREEMENT 425800 3.PROPOSED START DATE AND COMPLETION SCHEDULE NGL 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 suboonUactors 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 02116.617.973.8700. 5. Ep RMITS 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 CHANCES 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, 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 avallability 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 setup 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 thatthe 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 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 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 Contact 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 mall 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 Advisor Name: E' '��"��� �i 1 f C1n Tfcl=�l.� wl�f•� Customer f WI Address 10 G Advisor Phone #: 403AM-1091 - Any limitations to access by truck? Town NO a Site ID LIEU — NOTEs Any work scoped outside of Best Practices? Approved by: NY X340 ' In 5,VrrlQUEO Y�XMI-'Fu W( f&X fft-rr K (1i 33's 0} rifts �n�S, 1114 ./ SN�1►�lG 'ACc..F,SS,Oil 2 C�� �� of 11D VWf r q"2 i�X�Q op�lvt�c�ltS, 4 �c v�►) off- CauN6r is S\W1 6D I r 4 wAuY-_uw VAIWS �' wAu s Nn (No NEc�D-ro vam) � 1 r u 0 office ®rCl O�su er laffal and Business Regulation 10 Park Plaza e Suite 5170 ` d ' Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 162111 Type: Supplement Card Expiration: 1/14/2017 NEXT STEP LIVING INC. ROGER OUELLETTE 21 DRY®OCK AVE. 2TH FL BOSTON, MA 02210 Update Address and return card.Mark reason for change. Address ❑ Renewal F] Employment Lost Card CPS GA :;i riEllvtCl4tf)�.(;3111 k',",^16, Office of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. if found return to: M V HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation zt Type: 10 -Sgit`�190Registration: 162111 Pt Expirations 1/14!2017 Supplement Card Roston,MA 021)[6�,' NEXT STEP LIVlNC}NC. J ROGER OUELLETTE ... 21 DRYDOCKAVE.2TN`FL -�� gt/`val d without signature BOSTON,MA 02210 Undersecretary %Pd.� a..� i Dcartnedal of F'ubhc Safety B(,,jd�,fing Standards ' CSSL-102811 ROGERAOVEL14ET 55 STANMORE Wandek RI 028 x t 0911312016 Restricted T®: CSSWC-Unsuiati®n Contractor Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For OPS Licensing infoFmation visit: wwwAass.Gov/DPS NEXTS-1 OP ID: EL ®� CERTIFICATE OF LIABILITY INSURANCE DATE(M0/20 09/30/20 5 15 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 McLaughlin Insurance Agency PHONE FAX 828 Lynn Fells Parkway (AIC,No EXt:781-665-2775 A/c No;781-665-0295 Melrose,MA 02176 AE MAIL DDRESS: John E.McLaughlin Jr. INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Nautilus Insurance Company 17370 INSURED Next Step Living, Inc. INSURERB:A.I.M. Mutual Insurance Co. 21 Drydock Avenue,2nd Floor Boston,MA 02210 INSURER C:Commerce Insurance Company 34754 INSURER D:AXIS U.S.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 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. TR TYPE OF INSURANCE DDL BR POLICY NUMBER MM%POLICY EFF MMl POLICY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE N OCCUR ECP2010198-13 09/30/2015 09/30/2016 PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 '.. JECT POLICY❑ PRO ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000 000 Ea accident r C ANY AUTO 15MMBGKKDM 09/30/2015 09/30/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X Comp$1000 X Coll$1000 $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 D EXCESS LIAB CLAIMS-MADE ELU783547/01/2015 09/30/2015 09/30/2016 AGGREGATE $ 5,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION X PER OT--77—H- AND EMPLOYERS'LIABILITY STATUTE ER Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE TO BE ISSUED BY CARRIER 09/30/2015 09/30/2016 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? r N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 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 For Information Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth ofMassaehusetts Deptu'tment oflntlitstrialliccidents 1 Congress St��eet, Sti to 100 Boston,ADI 02114-2017 JVJVW mtcss.gov/rlia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. 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): LE)I am a employer with 850 employees(full and/or part-time).* 7. ®New Construction 2.®I am a sole proprietor or partnership and have no employees working for me in 8. El Remodeling any capacity.[No workers'comp,insurance required.] 9. ❑Demolition 3.[]l am a homeowner doing all work myself[No workers'comp.insurance required.]t 10®Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.0 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[:]Roof repairs These sub-contractors have employees and have workers'comp.insurance.# 14.�✓ Other Weatherizatipn 6.n We are a corporation and its officers have exercised their right of exemption per MGL C. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. .1 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 those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant ren employer tlsat is providing)porkers'compensation insurance far nzy 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 Expiration Date: 9/30/16 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 MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORD ORDER and a fine of up to$250.00 a day against the violator.A copy of this stat mermay be forwarded to the Office,of Investigations of the DIA for insurance coverage verification. I do Hereby certify under thepains rip Tallies ofperjwy that the information provided above is true and correct. Signature: Date: Phone#: (866)867-8729 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[rown Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: