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HomeMy WebLinkAboutINSULATE VINYL SIDED WALLS AND ATTIC WITH BLOWN IN CELLULOSE INSULATION 1 BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: � Date Received w 1� a SgcHus�4�y Date Issued: IMPORTANT: Applicant must complete all items on this page � � :: f r 1 r r'fr�rrflc rl �tf ff I3 r 9 /5 f I rirtt/ - rj ✓ r/ r �s�fi�{���s��err � PrARCEL� � ZONING QIST`RIGT� Historlc;alsfrrct ye',s no ,/ ` r f,r� ; rr , aching Shap VIl(age }red na .M TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Com ial ❑ Repair, replacement ❑Assessory Bldg thers: ❑ Demolition ❑ Other �i�S �firc��',D Well ,, ❑ Floodplain 0`Wetlands ❑ Watershed Distii^�ct`; /Identification Please Type or Print Clearly) OWNER: Name: '�` Phone: Address: - ORare t f ,� hone{ rfy,,( :.� r`tr'J✓;r ,:f{ 1 /fir rr// i tr r 1 / f 1rr rr r r ,r u , 4in �Cclonler�se i / ' , �/ r!�f, r;b'"e `a��rt'✓3 i /l!r J r l ������ r r ��—���� � ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. 7 Xe Total Project Cost: $ //, l ® � FEE: $ 1 L R Check No.: i 'Z-`6` 3 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guars d Signature,ofAgent/Owner Signature of contractor FORTH Townof � � EAndover 0 : ,,. No. -� h ver, Mass, COC NIC.KS .WICK y1. AERATED s � BOARD OF HEALTH Food/Kitchen PERMIT T LD\ Septic System 1 V THIS CERTIFIES THAT ................................. BUILDING INSPECTOR ........................ ... . ...................................... has permission to erect buildings on ..,. Foundation �/� '� �e��,,y, Rough to be occupied as .....�:.?C.."A.•rPL 4 .... �.!d. �:�! .�..... . ............................... Chimney provided that the person accepting this permit 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 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO S A TS 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 Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. CONTRACTOR WORK ORDER Conser atton Services Group 50 Washington St Suite 3000 Printed: 3/13/2015 Westborough,MA 01581 Work Order Id: S75774P80602C273 by r r ' `s��"►�t� . ��,�,`,__� �'h?n� r ,f � s,„ r ..rr_vz. z✓,._.._n ,"r . ,ter,,.., ,,..,, _-...,,, ,r,.�, .,. ,,, ,,, ,, ,,,,,,,,,,,w . >,, r Building Efficiencies LLC Donna M King Email: donnamking@comcast.net 18 Tan ua Ave 87 Glencrest Dr Phone(Eve): 978-794-1579 9 Y Phone(Day): 617-543-2278 Nashua, NH 03063 North Andover, MA 01845-1314 Site ID: S00002175774 r/�rir.%n�'rr"����rf�� r�rr�'r�r�rir�z� r rt f TOt"dl 111St 11p (�IP.�dS1,11'$S r � r �-.t Location Description Quantity Unit$ Total $ Exterior Door Weather Stripping 4 $27.59 $110.36 Door Sweep 4 $23.18 $92.72 Living Space Perform Air Sealing at Estimated 62.5 CFM50 10 $84.32 $843.20 Living Space Attic Stair Cover Thermal Barrier with carpentry 1 $260.23 $260.23 Living Space Insulate Vinyl Sided Wall With 4” Dense Pack 1,302 $2.41 $3,137.82 Attic Propavent 2'or 4' 4 $3.83 $15.32 Living Space Dense Pack 10"Cellulose In Overhang 50 $4.58 $229.00 Living Space Attic Floor Open Blow Cellulose 6" 1,232 $1.47 $1,811.04 Living Space Insulate Interior Buffered Wall With 4" Dense P 195 $2.31 $450.45 Living Space Insulate Rim Joist with 6.25"Fiberglass Batting 28 $2.40 $67.20 Damming 152 $2.19 $332.88 Living Space Insulate Buffer Wall From Interior With 4" Dens 224 $2.31 $517.44 Attic Vent bath fan to roof flapper 2 $129.21 $258.42 Installed Measures Total $8,126.08 f r inrJff � '''hi r f road flecks r x rrrrr r i , Type Status Notes Asbestos UNKNOWN { y rar�'Y��r'rr '���b�i.rr�rr r r r✓` Incentive Payments Air Sealing Incentive $1,306.51 Weatherization Incentive $2,000.00 Total Incentive Payments $3,306.51 Customer Share Total Customer Share $4,819.57 Less Deposit Of $1,606.52 Customer Share Balance(Due Contractor) $3,213.05 Conservation Services Group-50 Washington Street Suite 3000-Westborough, MA 01581 -(508)836-9500 CONTRACT FOR Conner atlon PRODUCTS / SERVICE WORK Services Group This service is brought to you through support from your local utility This Agreement is made by and among ' and Donna M King Conservation Services Group(CSG) t 87 Glencrest Dr Attn:RCS North Andover,MA 01845-1314 50 Washington Street, Suite 3000 Site 1D:S00002175774 Westborough,MA 01581 Project ID:P00000180602 Reg. No. 173484 Customer ID:C00000185832 Federal ID No.222457170 Contract ID:20150113 WORK (Mail completed contract to address above) 1. DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the following work on these"Premises"in a professional manner and in accordance with the terms of this Contract,including the attached recommendations/work order describing the work in detail(the'Work")which are incorporated herein by reference: Description Quantity Location Attic Floor Open Blow Cellulose 6" 1,232 Living Space $1,811.04 Pro vent 2'or 4' 4 Attic $15.32 Vent bath fan to roof flapper 2 Attic $258.42 Insulate Vinyl Sided Wall With 4'Dense Pack Cellulose 1,302 Living Space _$3,137.82 Insulate Wall From Interior With 4'Dense Pack Cellulose 224 Living Space $517.44 Insulate Interior Buffered Wall With 4"Dense Pack Cellulose 195 Living S ce $450.45 Dense Pack 10"Cellulose In Overhang 50 living Space $229.00 Insulate Rim Joist with 6.25'Fiberglass Batting 28 Living Space $67.20 Damming 152 N/A $332.88 Sub Total: $6,819.57 Utility Incentive Share $2,000.00 Customer Contribution $4,819.57 af�o o For office use only Printed:2/16/2015 Page 1 of 2 II. PAYMENT 1606.52 as a Deposit Customer agrees to pay Contractor for the Work,the Customer Share of the Contract Price-Ls follows:Payment Nl:$ payable to CSG upon signing the Contract(not to exceed I/3 of the total retail costs).Mail check&contract to CSG,Atm:RCS,50 Washington St.,Ste. 3000,Westborough,MA 01681.}final Payment:$ 321105 as the final payment for the Work shall be payable to the Independent installation Contractor("IIC")upon satisfactory completion of the Work.Customer understands that he/she will not be required to pay the Utility Incentive Share of the Contract price in the amount of$ 2000.00 Changes to individual line items and/or previous incentives may increase or decrease the size of the Utility Incentive Share. III.DISPUTE RESOLUTION The I1C and Customer hereby mutually agree in advance that in the event that the RG has a dispute concerning this Contract,the[IC may submit such dispute to a private arbitration service wild,has tarn approved by the Office of Consumer Affairs and Business Regulation avid Customer shall be required to submit to such arbitration as provided in M.G.L c 142A You may cancel*this agreement if it has been signed by a party at a place other than an address of the seller, provided you notify the seller in writing by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third basin s ay following the signing of this agreement. DO NOT SIGN THIS CONTRACT IF THERE �Y BLANK SPACES. Donna MKing(Feb 16, 15) Feb 16, 2015 Want program to assign contractor oMK . Customer Signature Date Indicate your selected 11C here,if applicable (OR) initial here if you want 2/16/15 Mark Couture 212 the Program to assign a Participating Contractor CSG Signature Date Name of CSG Representative(Printed) TERMS AND CONDITIONS APPEAR ON THE REVERSE. 3/14 (SGCONTRACT FOR Conser atlon PRODUCTS I SERVICE WORK Services Group This service is brought to you through support from your local utility FThis Agreement is made by and among and I Donna M King Conservation Services Group(CSG) 87 Glencrest Dr Attn:RCS North Andover,MA 01845-1314 50 Washington Street,Suite 3000 Site ID:S00002175774 Westborough,MA 01581 t Project 1D:P00000180602 Reg.No. 1.73484 I Customer ID:COOOOO185832 Federal ID No.222457170 Contract 1.D:201501 13_ASEAL (Mail completed contract to address above) I. DESCRIPTION OF WORK TO BE PERFORMED Contractor will perform or cause to be performed the following work on these"Premises"in a professional manner and it accordance with the temps of this Contract,including the attached recommendations/work oder describing the work in detail(the"Work")which are incorporated herein by reference: Description Quantity Location Perform Air Sealing at Estimated 62.5 CFM50 Per Hour 10 Living Space $843.20 Attic Stair Cover Thermal Barrier with carpentry 1 Living Space $260.23 Door Sweep 4 NIA $92.72 Exterior Door Weather Side ing 4 NIA $110.36 Sub Total: $1,306.51 Utility Incentive Share $1,306.51 Customer Contribution $0.00 as'❑O _ UY:7P; • For office use only Printed:2/16/2015 Page 2 of 2 11. PAYMENT 0.00 Customer agrees to pay Contractor for the Work,the Customer Share of the Contract Price as follows:Payment Al:$ as a Deposit payable to CSG upon signing the Contract(not to exceed W of the total retail costs).Mail check&contract to CSG,Attn:ACS,50 Washington St,Ste. 3000,Westborough,MA 01681.F)nal Payment,i (),70 as the final payment for the Work shall be payable to the Independent Installation Contractor("IIC")upon satisfactory completion of the Work.Customer understands that he/she will not be required to pay the Utility Incentive Share of the Contract price in the amount of s 1306.51 Changes to individual line items and/or previous incentives may increase or decrease the size of the Utility Incentive Share. 111.DISPUTE RESOLUTION The IIC and Customer hereby mutually agree in advance that in the event that the RC has a dispute concerning this Contract,the RC nuky submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and&Wness Reg,rl:nfon and Customershall be required to submit to such arbitration as provided in KC.L c 142A. You may cancel this agreement if it has been signed by a party at a place other than an address of the seller, provided you notify the seller in writing by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business d following the signing of this agreement. DO NOT SIGN THIS CONTRACT IF THERE A r BLANK SPACES. ...,� /ti' ,:,g Feb 16, 2015Want program to assign contractor 0Mx o CustomertSSg�nature5i Date Indicate your selected TIC here,if applicable (CR) Initial here if you want 2/16/15 Mark Couture 212 the Prograrn to assign a dG Si Ca'ucluut Participating Contractor CSG Signature Date Name of CSG Representative(Punted) TERMS AND CONDMONS APPEAR ON TM9 REVERSE. 3x14 i mass saver COIR PERMIT AUTHORIZATION FORM I, Donna M King ,owner of the property located at: (Owner's Name,printed) 87 Glencrest Dr N.Andover (Property Street Address) (city) hereby authorize the Mass Save Horne Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. 10 Hit, X gonna PA King(Feb 16,010 IS) Owner's Signature Feb 16, 2015 Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participating Contractor Date OffO 9119. For Office Use only Rev. 12132011=•-_..._.._..__._ The Commonwealth of Massachusetts LT Department of IndustrialAccidents Qfflce of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 Uf www.massgov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Ap licant Information ,. Please Print Leeibly Name (Business/Organization/Individual): '50a, 1'7c, — Address: Y / yG"_� /1�y9 City/State/Zip:/V .51vok /YP p304g Phone#: Are!!VAn employer?Check the appropriate box: Type of project(required): 1. lam a employer with... 4. ❑ I am a general contractor and I 6 ❑New construction employees(full and/or part-time).* Have hired the sub-contractors � ❑ Remodeling listed on the attached sheet. 2.❑ I am a sole proprietor or partner- These sub-contractors have 8. ❑ Demolition ship and have no employees working for me in any capacity. employees and have workers 9. ❑Building addition (No workers' comp. insurance comp. insurance.$ 10.[3 Electrical repairs or addition 5. ❑ We are a corporation and its 3.❑ I required.]a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or addition myself. [No workers' comp. right of exemption per MGL 12.[] Roof repairs insurance required.] t c. 152, 1(4),and or have no 13 aOther :!! �/D,y employees.es. [No workers comp. insurance required.] *Any applicant that checks box 01 must also flu 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 those entities have employm, If tho sub-contrectora have employees,they must provide their workers'comp.policy number. I ani an employer that is providing workers'compensation insurance for my employees. Below is the polley and Job site infonrtatlon. G/—} � � /9- . .s Insurance Company Name: Policy#or Self-ins. Lic. #: LCJ G Expiration Date: s Job Site Address:; l City/State/Zip: L— 4�� Jo Attach&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 fin 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 coverage verification. Ido hereby earn a ains penables of perjury that the information provided above e and correct. Official use only. Do not write in this area,to be completed by city or town of)`icial. 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#: BUILDI DATE(MMIDOI Client#:58637 pp 05/12120' ORM CERTIFICATE OF LIABILITY RN SU H��vTHECERTIFCA THEPOLICIES1 THIS CCERTIFICATE{8 IB6UED AS A MAT ER OF INFORMATION ONLY AND CO AUTHORIZED DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), CERTIFICATE DOES NOT AFFIRMATIVELY ORNEGATIVELYAMEND,EXTEND OR ALTER THE COVERAGE AFFORD t !!FLOW.THIS CERTIFICATE OF INSURANCE _ REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE MOLDER. an endorsement.A statement on this eortlfleate does not confer rights i tate holder is an ADDITIONAL INSURED,the policy(ies)must he endorsed.If SUBROGATION IS WAIVED,su IMPORTANT:if the Il Ce' policies may require the tems and conditions of the Policy' _ � 6 certificate holder in Ileo of such enolow"I IGnt(s). _-- -- NoFE603428 -iiiiboucii N 3238 C N Ilii T— Davis d'Towle Oroup E LE _ proctor Square INSURER!RER 8 AFFORDING COVERAGE p.0.Box 2300 INSURER A!Acadis Insurance Co. Henniker,NH 03242 INSURER 0; — INw REDINSURER C: Building Efficiencies LLC INSURER D 18 Tan9uay Avenue INSURER E Nashua,NH 03063 N URER F! REVISION NUMBER: LICY PI COVgRAGES CERTIFICATE NUM!lER: D HER IS SUBJECT TO ALL THE TI ITION Of ANY CONTRACTOR OTHERS OCUMENT WITH RESPECT TO WHICH THIS IS TO CERTIFY 7HAT TME POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSB RED NAMED ABOVE FOR THE POW INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM A CON D CLAIMS- OR -- uMYrs )TIONS OF SUCH POLICIES. LIMITS SHOWN MAY rlAve BEEN REDCUCEO BY PAID . 51 000 0 CE�Ip ,TE MAY BE ISSUED MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DE ENCE EXCLUSIONS AND CONDITIONS A00L UIBR POLICY NUMBER Typo LUAuRAWE CPA5048829t2 5/12/2014 05!1212015 EACH CURENTErD� s250001 A GiNERAL nY- UAlli MED EXP tA� 0 f°O" S5000 X COMMERCIAL GENERAL^LIABILITY PERSONAL 6 ADV INJURY sI,000,( CLAIMS•MADF I y pgcVR GENERAL AGGREGATs2,000.( ._� E PRODUCTS.COMPIOP AGG 52 000,1 011iAGGREGATE LIMIT APPLIES PER: COMBINED SINGLE LIMIT 1 QQQ POLICY J( PRO. LOC CAA507617812 5/12/20i4105H 2/2015 BODILY INJURY(PN M"*n) $ GE A AUTO"L!LIABILITY SODJURY I(Per student)I S X ANY AUTO BOHHDULEO OPER T1'DAMA (Per.��ude_=I� S �pNVNED AUTOS NON.owNeO s 0001 X HIREDAUTOB X AUTOS CUA5p8185912 5112/2014 05112/2015 EAC�O°OURREr'cE $5 01 AGGREGATE A uMeRtw+LIAa ;OCCUR $ axaassLy� •CWMbMAOE WCSTATU• 07H- N 0 WCAW4863412 5/12/2014105/12/2015EAC $5000 E.L. ACMACCIDENT owj"GOWaNaAT10M Y lN EL DISEASE EA EMPLOYEE$50 0 ot A M AND SWLOMaM�LIAatUE XECUTIVE YNIA. (WBCSIofY E MN1 X L D9 I E.L.DISEASE•POLICY LIMIT $500 05 G �oF OPERATIONS b-1 rpNa!LOCATIONa i VEHICLES(AtUch ACORD 101,AddlUorlal R�rna*�Seh�dul�.If mon sP+u Is n4Wntl) DBaCCR1►TION Oi'OPERA „� n Workers Comp Information ProprlewlypartnerWExecutive Offlcers/Membere Excluded:Jonathan Included states'NH S MA pertains to the work being done during CSG,National Grid.and NSTAR and named as additional Insured as it the policy period, CAN EL l AT ON TIFiC SHOULD ANY OF THE ABOVEDESCRIBED NOTICE POWL.LICIES BILE CBE COELe FLL THE EXPIRATION DATE THEREOF, Conservations Services Group ACCORDANCE WITH THE POLICY PROVISIONS. 50 Washington Street Westborough,MA 01581 AUTHORIZED REPREBENTAT VE ®1988.2010 ACORD CORPORATION.All right registered marks of ACORD ELS ACORD 25 2010105) 1 of 1 The ACORD name and logo are reg'I #918025VM160249 Massachusetts -Departn ent of Rubric Safety Board of Building Regulations and Standards C on%irurtioa S=;peri ii ,r License: CS-104159 -, ; ,� !" "' Z ANTIMONY J GREKO 42WHITTLER S AiEE ; HAVERMLL M Ol ' Exp�rattcn Commissioner 02/25/2016 (VeC(//' r1lt, e- 1, t� Office of Consumer Affairs and Business Regulation =;F�J 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 167942 Type: Supplement Card Expiration: 11/17/2016 BUILDING EFFICIENCIES, LLC ANTHONY GRIECO 18 TANGUAY AVE. NASHUA, NH 03054 - Update Address and return card.Mark reason for change. ! Address Renewal j Employment ( Lost Card SCA 1 0 2OM-05/11 ��r t t in�in'irinrrr�/l r�C, T ffice of Consumer Affairs&Business Regulation License or registration valid for individul use only �� ~~ ME IMPROVEMENT CONTRACTOR before the expiration date. 1f found return to: Office of Consumer Affairs and Business Regulation Registration: 167942 Type: 10 Park]Plaza-Suite 5170 tom' Expiration: 11/17/2016 Supplement Gard Boston,MA 02116 BUILDING EFFICIENCIES,LLC ANTHONY GRIECO 18 TANGUAY AVE. NASHUA,NH 03054 Undersecretary Noali without signature