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HomeMy WebLinkAboutBuilding Permit #246-2016 - 176 KARA DRIVE 8/27/2015 pORTFf Of SSL[O s ; BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: t'"I Date Received Date Issued: �4SS�cHUS�� IMPORTANT: Applicant must complete all items on this page LOCATION K14K, , AJ o 4A Aii 4overl OA PROPERTY OWNER Seo- 1 � K- P ti I Print MAP NO: PARCEL: ��~ZONING DISTRICT: Historic District y no =Machine Shop Village s no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential I I New Building One family ❑A�dition ❑Two or more family El Industrial RAlteration No. of units: I I Commercial Wpair, replacement ElAssessory Bldg El Others: emolition ❑ Other ❑ Septic ❑Well ❑ Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer 1 Identification Please Type or Print Clearly) 0- 1' s60 OWNER: Name: S� Gl ���� / Phone: �0~�0/�" a J? Address: Ir%C r o CONTRACTOR Name: ���G�s CiU 1� ��: Phone: Address: 1161 Supervisor's Construction License: CS OY130y Exp. Date: J_y_ Z�01� Home Improvement License: / Exp. Date: 9- ^2-o/b ARCHITECT/ENGINEER /U/ 4 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. Total Project Cost: $ (OJ, C/ �- D0 FEE: $ 7 d 4 Check No.: I Zbo O Receipt No.: x°12 ,,,— NOTE: Persons contracting ` unregistered contractors do not have access to guaranty fund Signature of Aden Owner Signature of contractor T� J, �� r BUILDING PERMIT F.D A, N ".6 � O •(t LE TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION * ,� Permit No#• Date Received 7RpDAArED �SSACHU5�4 Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print 100 Year Structure yes no MAP PARCEL: ZONING DISTRICT: 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 0 Septic ❑Well a Floodplain 0 Wetlands ❑ Watershed,District El Water-/Sewer DESCRIPTION OF WORK TO BE PERFORMED: Identification- Please Type or Print Clearly OWNER: Name: Phone: Address: Contractor Name: Phone: Email: Address: Supervisor's Construction License: Exp. Date: 121 Home Improvement License: Exp. Date: y. a 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 unregistered contractors do not have access to the guaranty fund Signature of contractor �iq „- Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineeredproducts to issuance of Bldg Permit OTE: All dumpster permits require sign off from Fire Department prior g Addition Or Decks 4 Building Permit Application Certified Surveyed Plot Plan Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 4 Building Permit Application 4, Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit • Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) • Copy of Contract 2012 IECC Energy code 4, Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Plans Submit-ed ❑' Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ TanaiugisageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zonin Decision/recei g pt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature Date Drivewav Permit DPW Town Engineer: Signature: Located84 Osgood Street F R RTMEN q- p pS ,`on si e t'es' t `� =s 3no P Located at 124 IUlain treet = Fire De �n ,} ��p sigat a/date �r _ Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) i k +i i ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 I I i 1 ' Location No. 2-�{0 ^�L O ( Date T l . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ Aim" kr.. Other Permit Fee $ a TOTAL $ Check �' Building Inspector 2262 ® o® McCormick Kitchens e m 9161 Broadway Saugus,, MA 01906 (781) 231-4200 Fax (781).231-4270 www.mccormick-kitchens.com PHONE DATE TO: SCOTT HAJJAR & LINDA JALBERT 5/1/2015 176 KARA DRIVE JOB NAME/LOCATION NORTH ANDOVER MA 01845 (C) 978.618.0932 - SCOTT (C) 978.390.3345 - LINDA JOB NUMBER JOB PHONE We hereby submit specifications and estimates for: PAGE 1/3 MCCORMICK KITCHENS IS FULLY LICENSED AND INSURED: COMMONWEALTH OF MASSACHUSETTS HOME IMPROVEMENT CONTRACTOR REGISTRATION #: 131725 MASSACHUSETTS DEPARTMENT OF PUBLIC SAFETY LICENSE NUMBER: 51304 JOB START DATE: 08.31.15 1 JOB COMPLETION DATE: 11.06.15* *INSPECTIONS/PERMIT SIGN OFFS MAY EFFECT COMPLETION DATE* MCCORMICK KITCHENS TO DEMO EXISTING KITCHEN CABINETRY & COUNTERTOPS & PREP FOR NEW. MCCORMICK KITCHENS TO DEMO FLOORING IN EXISTING KITCHEN AREA & PREP FOR HARDWOOD. MCCORMICK KITCHENS TO PURCHASE & INSTALL RED OR WHITE OAK HARDWOOD FLOORING IN KITCHEN ONLY. MCCORMICK KITCHENS TO REMOVE ANY RELATED DEBRIS FROM SITE ONCE DEMOLITION IS COMPLETED. MCCORMICK KITCHENS TO PURCHASE, DELIVER AND INSTALL MEDALLION GOLD KITCHEN CABINETS AS DESCRIBED BELOW AND SHOWN ON PRINTS. MCCORMICK MCCORMICK KITCHENS TO PURCHASE & INSTALL COSTA ESMERALDA GRANITE COUNTERTOPS WITH ONE OF THE (3) STANDARD NON-UPCHARGE EDGES NOTED IN CONTRACT PACKAGE. IF COUNTERTOP MATERIAL (OR) EDGE IS UPGRADED, ADDITIONAL CHARGES WILL APPLY. Cuss. Office FM Cust. Office FM V1AKE Sr2: PAC,rr 0 0 DOOR SLS PAcj6;:._ 3 0 KOOD ' (� 0 STAIN "LDGS. 0 0 ACCESS r 0 WE PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: dollars($ ) Payment to be made as follows: All material is guaranteed to be as specified.All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized 5 I2 J j involving extra costs will be executed only upon written orders,and will become an extra Signature QJIA charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to cavy fire,tornado,and other necessary insurance.Our Note:This prop sal y workers are fully covered by workers Compensation insurance. withdrawn by us i a ep it days. ACCEPTANCE OF PROPOSAL—The above prices, S� specifications and conditions are satisfactory and are hereby accepted. You are Signature authorized to do the work as specified.Payment will be made as outlined above. Signature Date of Acceptance: 94® McCormick Kitchens i I G I Broadway Saugus, MA 61906 (781) 231-4200 Fax (781):231-4270 www.mccormick-kitchens.com PHONE DATE TO: SCOTT HAJJAR & LINDA JALBERT 5/1/2015 176 KARA DRIVE JOB NAME/LOCATION NORTH ANDOVER MA 01845 (C) 978.618.0932 - SCOTT (C) 978.390.3345 - LINDA JOB NUMBER JOB PHONE specificationsWe hereby submit PAGE 2/3 IF CLIENT OPTS TO HAVE MCCORMICK KITCHENS INSTALL TILE BACKSPLASH, COST TO BE BETWEEN $750-$1, 000, DEPENDING ON COMPLEXITY OF DESIGN. COST IS NOT INCLUDED IN CONTRACT TOTAL. ALL TILE BACKSPLASH MATERIALS TO BE PROVIDED BY CLIENT AND ARE TO BE ON SITE WHEN COUNTERTOP IS INSTALLED. PLUMBING: MCCORMICK KITCHENS TO PLUMB KITCHEN TO CODE. MCCORMICK KITCHENS TO DISCONNECT & RECONNECT SINK, DISHWASHER, FAUCET, RUN WATER LINE TO REFRIGERATOR (IF APPLICABLE) , AND CONNECT GAS (OR) PROPANE LINE TO RANGETOP. ELECTRICAL: MCCORMICK KITCHENS TO WIRE KITCHEN TO CODE. MCCORMICK KITCHENS TO PURCHASE AND INSTALL (4) UNDER CABINET LIGHTS, AND INSTALL PENDANT LIGHTS/FIXTURE(S) ABOVE ISLAND (CLIENT TO PROVIDE) . MCCORMICK KITCHENS TO INSTALL ALL APPLIANCES, INCLUDING VENTING OF THE HOOD AND PATCHING THE EXTERIOR AS NECESSARY. (3) lW-V1z'0 - L-1c,14.1-S ?N,- MCCORMICK NCMCCORMICK KITCHENS TO PROVIDE (1) FREE STAINLESS STEEL UNDERMOUNT AMERISINK AS125 SINK, AND FREE BRUSH NICKEL STOCK KNOBS. IF CLIENT OPTS FOR DIFFERENT SINK OR KNOBS, ADDITIONAL CHARGES TO APPLY. Cult. Office. FM Cust. Office FM IIS MAKE s� DOOR_� 0 � 0 WOOD [� STAIN MLDGS. t 0 0 ACCESS 0 WE PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: dollars($ ). Payment to be made as follows: All material is guaranteed to be as specified.All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:TWtedn workers are fully covered by Worker's Compensation insurance. withdrawn by us idays. ACCEPTANCE OF PROPOSAL—The above prices, x2r specifications and conditions are satisfactory and are hereby accepted. You are Signature authorized to do the work as specified.Payment will be made as outlined above. Signature Date of Acceptance: _ I ® a® McCormick Kitchens iPROPOSAL 91161 Broadway Saugus,, MA 61906 (781) 231-4200 Fax (781) 231-4270 www.mccormick-kitchens.com PHONE DATE TO: SCOTT HAJJAR & LINDA JALBERT 5/1/2015 176 KARA DRIVE JOB NAME/LOCATION NORTH ANDOVER MA 01845 (C) 978.618.0932 - SCOTT (C) 978.390.3345 - LINDA JOB NUMBER JOB PHONE We hereby submit specifications and estimates for: PAGE 3/3 MCCORMICK KITCHENS IS NOT RESPONSIBLE FOR: PURCHASING OF APPLIANCES, HVAC, PURCHASING OF SPECIALTY LIGHTS OR WITCHES, REMOVING OF WALLPAPER, PAINTING, STAINING, FINISHING OF HARDWOOD FLOORS, PURCHASING OR INSTALLATION OF BACKSPLASH, FAUCET, OR PERMIT FEES. *** ALL PAYMENTS MUST BE RECEIVED IN THE ORDER LISTED BELOW. *** PAYMENT SCHEDULE IS AS FOLLOWS: '_$5, 000 DEPOSIT, 3I3oj1,5 531t " 12, DUE UPON SIGNING OF CONTRACT 51 $12, 000 DUE UPON START, $12, 000 DUE UPON DELIVERY OF CABINETRY TO MCCORMICK KITCHENS, $8, 500 DUE UPON ROUGH ELECTRICAL/PLUMBING COMPLETION, $6,500 DUE UPON COUNTERTOP TEMPLATE, $6, 000 DUE UPON COUNTERTOP INSTALLATION, $3,468 DUE UPON COMPLETION "I IF C U L7--T O PY3 fbD L 5:nJ h D M2..D t'A+^tti 9 )'i ,rv+t T�2_ CN t Cu S RjYY\ Gi u�1Z PjZ-C46(4A1rn'J C R E_-b tTT TID {R Bt 1SSub IN T•14t,-_ Lh�our�r—u a ,�}uo,"� . diP2jl� Wtrjf_ Cuxoia-r-� I.t. Office F cus& Office F MAKE (YIEbtAuaorJ Cot--0 DOOR Pee i,t,,� iSI.gNU WOOD STAIN c, -rb,, c�+�2 PEcaJ ALDGS.-T-V, DCm8P, bLE5 ACCESS -ncr bowNzlary /cc- b+J WE PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: Sixty Five Thousand Four Hundred Sixty Eight and 00/100 Dollars dollars($ 65,468.00 �. Payment to be made as follows: S All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This p po I m be workers are fully covered by Workers Compensation insurance. withdrawn by us if not d thin days. ACCEPTANCE OF PROPOSAL—The above prices, S specifications and conditions are satisfactory and are hereby accepted. You are Signature authorized to do the work as specified.Payment will be made as outlined above. Signature Date of Acceptance: _ --303A" ---- 7 r• T C5- r U l 24•,--i=— 25' a �— --- 231 -n 3 _I { I i 3I — ' I 9. 36-- 512 36 ' III 21 I I I • ��, I �•,- __ s,.r 14V"o VV24360I ... W24988 R,I 24W3012B 24W1818- 1CLMHOODE423 W O 3DB213F DC12 ' ,) O� I v I CD � i }��;[��I j ^ Ili 36:1' I O Cn U) �- i � N I t i j r)__�, T &R BW24LD D 48 -n I_— •� I i C� CO li { I III r! "!!00 j �w•�� I �� � °I w I rn � I CO i l0i j 1011 bi �� 1 J , m I .iy i 1 { P4 li m i y l i A c0 I i �` •{ 1 I t Ox i 00 293'=1 -241 G { I�_(----49­--)I —160 s' I r 643"' _�14"- . 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I hajjar_appt_032815_likes_050215 --- -- - All --- -' Drawing #: 1 I 2\- The Conntnanvealth of 1Vassachusetts _---- Departinent of Industr'ialAccidents Office of Investigations 600 Nashington Street ` Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Coutractors/Electricians/Plumbers Applicant Information Please Print Lc ibl Name(Business/Orgalhizatiou/Individual): VAA Z"Uia-12 jl-(—. :Ad:&.eSss: / tate/Zip: Phone#:c�yu uu employer? Cliec lite Appropriate box: Type of project(required): ln 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 listed on the attached sheet. 7. Vemodeling 2.❑ I am a sole proprietor or partner- These sub-contractors have ship and have no employees 8. nzolition employees and have workers' working for me in any capacity. 9. [(Building addition [No workers' comp. insurance comp. a corpora required.] 5. [� We are a corporation and its 10•�trtcal repairs or additions 3.❑ .1 am a homeowner doing all work officers have exercised their I i. Plumbing repairs or additions myself.[No workers' comp. right of exemption per MCL 12 Q Roof repairs c. 152 1 4 and we have no insurance required.]# 3. Other 1 ❑ employees. o workers [�`I comp.insurance required.} _.......-._ *Any applicant that checks box A] must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this uffidavil indimling they ure doing all work and then hire outside contractors must submit a new affidavit indicating such. tcontracton;that check this box must attached an additional sheet showing the name of the subcontractors 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 providiutg workers'compensation insurance for my etrtployeex Below is the policy and jub site information.Insurance Company Name: Policy#or Self ins.Lic.#: D� l .� S '► ` 1� Expiration Dat . I/l City/State/Zip: Job Site Address: ............. ......--l'.....- .......-----1 74�" .. - Attach-n-copy-of-the-wor-iter-s—compensation-policy-deciar-ation-page-(showing-tile-policy-uuntber-anti-expiration-date Fuilure to secure coveruge 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$254.00 a day against the violator. Be advised that a copy of lliis statement may be forwarded to the Office of Investigations of til D for insurance coverage verification. I do hereby certif u d r the pains and penalties of perjruy that the inforlitatiou provided above is true and correct. Si slur • Date: ���`� Phone b: FFhe only. Do not write In this area, to be completed by clop or town official Town: Permit/License# hority(circle one): Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector rson: Phone#: ACC> CERTIFICATE OF LIABILITY INSURANCE rDATE(MMIDDIYYYY) `..� 1 8/26/2015 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(les)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). CONTACT PRODUCER TGA Cross Insurance, Inc. NAME: TGA Cross Insurance Inc. 401 Edgewater Place, Suite 220 A/ N 781-914-1000 ac No: 781-246-2601 Wakefield, MA 01880 E-MAIL ADDRESS: switchboard@tqacross.com INSURERS AFFORDING COVERAGE NAIC A www.tgacross.com INSURER A: Employers Mutual Insurance Co. INSURED INSURER B: Hartford Accident and Indemnity Co. 22357 McCormick Kitchens Inc. 1161 Broadway INSURER C: Saugus MA 01906 INSURER D: INSURER E: INSURER F; COVERAGES CERTIFICATE NUMBER: 26119464 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIY MM/DD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY 5D30150 5/1/2015 5/1/2016 EACH OCCURRENCE $_ 1,000,000 CLAIMS-MADE ❑✓ PREMISES OCCUR DAMAGEOCCURD 100,000 Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑JET LOC PRODUCTS-COMP/OP AGG $ 2.000,000 OTHER: $ A AUTOMOBILE LIABILITY 5Z30150 5/1/2015 5/1/2016 Ee aB tleD SINGLE LIMIT $ 1,000,00 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ ✓ HIRED AUTOS ✓ AUTOS Per accident A �/ UMBRELLA LIAB OCCUR 5J30150 5/1/2015 5/1/2016 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED ✓ RETENTION$0 $ B WORKERS COMPENSATION 08WEC2557MN02 5/1/2015 5/1/2016 V' STER I ATUTE EER AND EMPLOYERS'LIABILITY -- ANYPROPRIETORIPARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? El N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Evidence of Insurance for Operations Usual to the Named Insured i CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 120 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. North Andover MA 01845 AUTHORIZED REPRESENTATIVE Thomas I Gregory ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 26119464 1 303078 1 Master Certificate I Amanda Stricos 1 8/26/2015 11:57:41 AM (EDT) I Page 1 of 1 License or registration valid for individul use only Office of Consumer Afrairs& Business Regulation before the expiration date. If found return to: IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation �egistration: 131725 Type: ,l=xpiration: 9/6/2016 Private Corporatio 10 Park Plaza-Suite 5170 Boston,MA 02116 McCORMICK BUILDERS GROUP. INC. FRANCIS McCORMICK JR. 1161 BROADWAY C�..G...-�6..P� -- __. --E (•/ — -- — SAUGUS,MA 01906 Undersecretary Not v ithout signature Massachusetts - Department of Public Safety Board of Building Regulations and Standards Z✓c,11itruition SuperZ icor License: CS-051,304 FRANCIS MCCO]3?MCh= , 1161 BROADWAY 1F /~= ROUTE 1 SOUTH Saugus MA 01906, Expiration 01/05/2017 commissioner Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 65,468.00 m $ - $ 785.62 Plumbing Fee $ 98.20 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 98.20 Total fees collected $ 1,082.02 176 Kara Drive 246-2016 on 8/27/2015 KITCHEN REMODEL NORT#i own of s EAndover 0 . - No. a I� ver, Mass COCNICNl WICK �•9 q�R^TeD S U BOARD OF HEALTH Food/Kitchen PER IT T LD Septic System THIS CERTIFIES THAT ........ r....... 1.... !a1A �4►` �'. BUILDING INSPECTOR has permission to erect .......................... buildings on .fl.�*...... fhult ..................... Foundation Rough 1 tobe occupied as ............... ...l. .. ....... ...... .dl........................................................ 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 - THS ELECTRICAL INSPECTOR 5-V UNLESS CONSTRUCT ON VA 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.