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HomeMy WebLinkAboutBuilding Permit # 3/11/2015 ,I NORTH BUILDING PERMIT o �t.ea TOWN OF NORTH ANDOVERCob APPLICATION FOR PLAN EXAMINATION - � Permit No#:_ tl m Date Received �q A�aAreo SSAGHUS� Date Issued: MPORTANT:Applicant must complete all items on this page r1 �! ° �� I � ( r P,rin�i , ll 00 ,:Year�f ue♦u' � es �/:i�J � . , TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 5rRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other / a/ /., , ! / r ,. Irr , T t i//l,, /r/a l ,, / ✓/G/l�/% ,r i // r, ��./ ,,,(/ l 1, ,/✓,// �., ,/if � ,. , ;, %.. /1. ,.... ,. ❑/Se tip /,❑Well / //, , ood la //,❑ et(a ds/ rer, ❑ �n ❑ Wate e , / / / I �>fff�� v,�, DESCRIPTION OF WORK TO BE PERFORMED: cl �' C c 4 t✓' 1 , , 4� /1✓ k ! Identification- Please T7 o rint Cl rl YP Y ` � ' Phone: t / OWNER: Name: c Address: ills/, ////�., ri/J/ 1,//i. r/JJ����i'�/�%r.r/,/l/J ///� , /r l r a ! �}�r�luJa»rri7tJ�%reel/�1�r�iii11111r'rnlir%/errnr'oi��Urrrrl/>�,iflaroi�rf»�Ifr�N,uHe�/Hmo/w 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. Total Project Cost: $ FEE: $ r Check No.: ��:, Receipt No.: �r NOTE: Persons contracting with unregistered contractors do not have access to the guaranty��cnd� Si nature of A 'ent/Owner Signature of contr ; `- r g g � , J , tAORi}� Town of Andover ® " - 1 ver, mass, 11 COC NIC Nl w�CK 1' S RATED ll BOARD OF HEALTH Food/Kitchen L U PERMIT T Septic System !�•.�,� BUILDING INSPECTOR THIS CERTIFIES THAT ............ . . ........ ��t�• `• ................................................. has permission to erect .. buildings on s Foundation Rough tobe occupied as .......K-x.. ................. ....... . .�......... ......................... 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 jok PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR `• UNLESS CONSTRUCTIO AR 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. Massachusetts Home Improvement Sample Contract This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should fust obtain a copy of"A Massachusetts Consumer Guide to Home hnprovement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757 or on our website. Homeowner Information Contractor Information Name Company Name CLIFTON AND BEVERLY STONE WALSH GENERAL CONSTRUCTION Street Address(do not use a Post Office Box address) Contractor/Salesperson/Owner Name 17 HALIFAX ST.NORTH ANDOVER MA JAMES WALSH City/own State Zip Code Business Address(must include a stred address) 978-686-7618 15 MARLYN RD.BILLERICA MA 01821 Daytime Phone Evening Phone City/Town State Zip Code 978-361-5697 Mailing Address(it different from above) Business Phone Federal Employer ID or S.S.Number Home tmpmsa m C,m1—tor Reg.Nmnher n irohon dote Ian regnises that most home a p a Zg,'.ao o�mc`ore 126909 08/05/2015 The Contractor agrees to do the following work for the Homeowner: (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheds if necessary.) SUBMITTED ON ADDITIONAL SHEET Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions of 03/16/2015 Date when contractor will begin contracted work. MGL chapter 142A.) 04/30/2015 Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: $13,675 M Payments will be made according to the following schedule: $SUBMITTED upon signing contract(not to exceed 1/3 of the total contract price or the cost of special order items,whichever is greater) $ ON by / / or upon completion of $ADDITIONAL by / / or upon completion of $ SHEET upon completion of the contract. (Lacy forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ to be paid for '.. ordered before the contracted work begins in order to meet the completion schedule.(**) $ to be paid for NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express warranty-Is an express warranty being provided by the contractor? []No®Yes(all terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most 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 the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies of the contract must be completed and signed.One copy should go to the homeowner.The other copy should be kept by the contractor. l Ho eowne's Si I to a Co�Sigpn.tlue Date Date Proposal PAGE I OF I 5 1Marlyn rd. WALS11-1 LIQ 071 -)100 99 1 5 M( Billerica REG#126909 il� GENERAL CONST." jj F RUCHON ree rEstimates RESIDENTIAL-COMMERCIAL 978-361-5697 PROPOSAL SUBMITTED TO rELEPHONE DATE STONE 978-686-7618 0310512015 STREET JOB NAME 17 HALIFAX ST SAME CITY,STATE AND ZIP CODE JOB LOCATION NORTHANDOVER A". SAME ARCHITECT DATE OF PLANS JOB TELEPHONE# We hereby submit specifications and estimates for KITCHENAND BATH REMODEL CONSISTING OF THE FOLLOWING 1. THE REMOVAL OFALL EXISTING CABINEISAND APPLIANCES 2 THEREMOVAL OF THE EXISTING HARDWOOD FLOOR. 3. THEREMOVAL AND REPLACEMENT OF ONE EXTERIOR DOOR(CUSTOMER TO CHOOSEAND PURCHASE DESIRED DOOR.EXISTING STORM DOOR TO BE REUSED) 4. THE IiNSTALLA TION OFNEWSUBFLOOR AND TILE TO THE ENTIRE KITCHENAND HALLARF,4(TILE TO BEANADDITIONAL COST) 5. THE INSTALLATION OFA NEWSTOVE EXHAUST(SUPPLIED BY CUSTOMER.ADDITIONAL COST WHENINSTALLATIONISDETERMI(VD) 6 THE INSTALLATION OFALL NEW CABINETS SUPPLIED BY CUSTOMER(ACCORDING TO NEW LAYOUT) Z THE INSTALLATION OFNEWDRYWALL TO WALL ARFASNECESSARY(TAPE,COMPOUND,AND PRIME) 8. REMOVE THE EXISTING WALL PAPER(NOT TO INCLUDE REPAIR OF WALLS UNDER WALLPAPER IFNECESSARI) 9. PURCHASE AND INSTALL 3 SOLID MASOITE 6 PANEL INTERIOR DOORS 10. PAINT ENTIRE KITCHENAND FOYER AREA INCLUDING DOORS,CHAIRAIL AND MOLDINGS(KILOZ PRIMER AND 2 COATS) 11. THE INSTALLATION OFNEW TILE TOALL BACKSPLASHAREAS OFNEWKITCHEN(TILE WILL BE ANADDITIONAL COST) 12. PLUMBINGAND ELECTRIC NECESSARYSUBMITTED ONSEPARA TE PROPOSALS 13. THE REMOVAL OF THE EXISTING FINISH FLOOR BASE MOLDINGSAND ONESUBELOOR 14. FRAMEA NEW CLOSETAREA WHERE THE TUB IS.TOACCOMMODATEA NEW WASHER DRYER AND SHELVING 15. THE INSTALLA TION OFNEWBIFOLD DOORS TO THE NEW LA UNDR YARFA 16 THE INSTALLATION OFNEW 318S SUBFLOOR AND TILE TO THE ENTIRE FLOOR AREA(TILE TO BEANADDITIONAL COST) IZ THE INSTALLA TION OFNEWPRE-PRIMED BASE MOLDINGS 18. THE INSTALLATION OF VANITY AND(CUSTOMER TO SUPPLY VANITY,TOILET,SINK TOP,FAUCETS) 19. THE INSTALLATION OFANY TOWEL BARS,MEDICINE CABINETS OR ACCESSORIES SUPPLIED BY CUSTOMER 20. FINISH ANY WALL AREAS ALTERED 21 PAINT THE ENTIRE BATH INCLUDING KILZPRIMER AND 2 COATS ONALL EXISTING 6 PANEL P17VEDOORS(BATHROOMSIDE) 22 OBTAIN PERMIT NECESSARY 23. CLEAN-UPAND DISPOSAL OFALL WORK RELATED DEBRIS 24. A FIVE YEAR PERSONAL GUARANTEE UPONALL WORK SPECIFIED 25. THIS PROPOSAL DOESNOTINCLUDEANYADDITIONAL DAMAGED AREAS UNCOVERED,. 26 PROPOSED START DATE 0311612015 PROPOSED COMPLETIONDATE0510112015 WeProposebereby to furnish material and labor-complete in accordance with above specifications for the sum of: THIRTEEN THOUSAND SIX HUNDRED AND SEVENTY-FIVE dollars($ I3,675 Payment to be made as follows: All or deviation from material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices.Any Authorized alteration above specifications involving extra costs will be executed only upon Signature: written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our Note:This proposal may be withdrawn by us if not accepted control. Owner to carry necessary insurance. Our workers are fully covered by workman Compensation Insurance. within days. ACCEFrANCF:0FPR0P0SAL-The above prices specifications and conditions are DO NOT IG T�IMEARE SPACES prices specifications XL7 I satisfactory and re hereby !epted/ authorized to do the work as Signator will in , "i specified. Payment be dined Signatur t r6 Date of Acceptance: Signatu, -1 Proposal PAGE I OF] 072199 15 Marlyn rd. 01, L VII LIC# Billerica REG#126909 )09) GEWERAL CONSTRUCTION Jim Free Estimates RESIDENTIAL- COMMERCIAL 978-361-5697 PROPOSAL SUBMITTED TO rELEPHONE DATE STONE 978-686-7618 0310512015 STREET JOB NAME 17HALIFAX ST SAME CITY,STATE AND ZIP CODE JOB LOCATION NORTHANDOVER ALL. SAME ARCHITECT DATE OF PLANS JOB TELEPHONE# We hereby submit specifications and estimates for KITCHENAND BATH REMODEL PATMENTSC/IEDULE CONSISTING OF THE FOLLOWING 1. THE INITIAL PAYMENT OF$2,000 UPON SIGNING THE PROPOSAL 2. THE SECOND PAYMENT OF$2,000 UPON THESTART OF WORK 3. THE THIRD PAYMENT OF$2000 UPON THE COMPLETION OFALL OLD FIXTURE AND MATERIAL REMOVAL 4. THE FOURTHPA YHENT OF$2000 UPON THE INSTALLATION OF CABINETRY 5 THEFIFTHPAYMENT OF$2000 UPONTHE COMPLETIONALL FLOOR INSTALLATION 6 THE FINAL PAYMENT OF$3,675 UPON THE COMPLETION OFALL WORK SPECIFIED WeProposcherelly to furnish material and labor-complete in accordance with above specifications for the sum of: THIRTEEN THOUSAND SLYHUNDRED AND SEVENTY-FIVE dollars 13,675 Payment to be made as follows: All or deviation from material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices.Any Authorized alteration above specifications involving extra costs will be executed only upon Signature: written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our Note.This proposal may be withdrawn by us if not accepted control. Owner to carry tire,tornado and other necessary insurance. Our workers are fully covered by Workman Compensation Insurance. within days. ACC- The-The above prices,specifications and conditions are DO THERE ARE N BLANKSPACES satisfactory atisfactory and re hereby accepted. You re authorized to do the work as specified. pecified. Payment will beinade as outs' have- Signa flode t Date of Acceptance Signature:- ' SPECIAL SERVICES CUSTOMER INVOICE Page 1 of 3 No.--26-68-4-27-89-2 A Store 2668 TEWKSBURY Phone: (978) 640-0400 85 MAIN STREET Salesperson: KRB650 TEWKSBURY, MA 01876 Reviewer: Name Home Phone REPRINT WALS H JIM (978)361-5697 Address 15 MARILYN RD work Phone Company Name LAY Job Description DES CON CHARLOTTESVILLE LINEN BILLERICA SQ. DESIGN 2015-01-26 11:28 State MA Zip 01821 county MIDDLESEX VENDOR DIRECT SHIP #1 MERCHANDISE AND SERVICE SUMMARY sWe the r ortoc stomer9httolimit the quantities ofmerchandise d TO: CUSTOMER SIO-MERCHANDISE TO BE SHIPPED: S/O AMERICAN REF# S06 ESTIMATED ARRIVAL DATE: 02/23 0 WOODMARK O P.O.#68522415 REF# SKU QTY UM DESCRIPTION F-=== EACH EXTENSION S0601 1001-197-559 1.00 EA VSDB30R/VSDB30R VANITY COMBO VSDB30R/VSDB30R FSIDES:B $585.46 $585.46HINGES:RS0602 1001-197-559 1.00 EA BWBT18-2/BWBT18-2 READING SQUARE W/DFO PAINTED SI/B 18- $0.00 $0.00 FSIDES:B HINGES:R -- - - S0603 1001-197-559 1.00 EA B36 1T 2FWT BU/B36 1T 2FWT BUTT BASE WITH 1 /B36 A Y $666.63_ $666.63- 11 2FWT BUTT FSIDES:B HINGES:B S0604 1001-197-559 1.00 EA BSS36L WD/BSS36L WD BASE SUPER SU SPIN BSS/ A Y $598.81 $598.81* BSS36L WD FSIDES:B HINGES:B S0605 1001-197-559 1.00 EA DB15 4DWR/DB15 4DWR 4 DRDB15 4DWR/DB15 4DWR A Y $590.87 $590.87* FSIDES:B HINGES:L M4- S0606 1001-197-559 1.00 EA WTCDKI5/WTCDKI5 1 SQUARE W/DFO PAINTED SIL/ATT:DB15 A Y $0.00 $0.00 4DWR WTCDKI5 E S0607 1001-197-559 1.00 EA SB30 BUT T SINK/RANGE BASE SB30 BUTT/SB30 BUTT A Y $336.92 $336.92* FSIDES: S:B S0608 1001-197-559 1.00 EAM[R�IDWR3{R) RIGHT DISHWASHER RETURN DWR3/DWR3{R} A Y $48.69 $48.69* S:R HINGES:L **CONTINUED ON NEXT PAGE*** O Check your current order status online at www.homedepot.com/orderstatus * Indicates item markdown Page 1 of 3 NO. 2668-427892 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALSH Page 2 of 3 NO. 2668-427892 VENDOR DIRECT SHIP #1 (Continued) TO: CUSTOMER S0609 1001-197-559 1.00 EA WTEP96/WTEP96 WOOD TALL END PANEL WTEP96/WTEP96 FSIDES:B A Y $179.64 $179.64* HINGES:L MODS:W=0 3/4" H=90" D=24" S0610 1001-197-559 1.00 EA UT1524 X 90R4130/UT1524 X 90R4ROT UTILITY WITH DROTS UT15/ A Y $979.37 $979.37* UT1524 X 90R4ROT FSIDES:B HINGES:R S0611 1001-197-559 1.00 EAl B15R/B15R BASE CABINET B15R/B15R FSIDES:B HINGES:R A Y $283.18 $283.18* S0612 1001-197-559 1.00 EA W1836L/W1836L WALL CABINET W1836L/W1836L FSIDES:B HINGES:L A Y $216.44 $216.44* S0613 1001-197-559 1.00 EA SRK18{L}/SRK18{L}SPICE RACK KIT SRK18{L}/ATT:W1836L SRK18{L} A Y $42.57 $42.57* FSIDES:B S0614 1001-197-559 1.00 EA W3018 BUTT/W3018 BUTT WALL CABINET W3018 BUTT/W3018 BUTT A Y $220.04 $220.04* FSIDES:B HINGES:B S0615 1001-197-559 1.00 EA W1836R/W1836R WALL CABINET W1836R/W1836R FSIDES:B HINGES:R A Y $216.44 $216.44* S0616 1001-197-559 1.00 EA W3036 BUTT/W3036 BUTT WALL CABINET W3036 BUTT/W3036 BUTT A Y $332.95 $332.95* FSIDES:B HINGES:B S0617 1001-197-559 2.00 EA W2736 BUTT/W2736 BUTT WALL CABINET W2736 BUTT/W2736 BUTT A Y $292.91 $585.82* FSIDES:B HINGES:B S0618 1001-197-559 2.00 EA 20FDCLEAR36-42/20FDCLEAR36-42 TWO OFD CLEAR 36" -42"/ A Y $207.42 $414.84* 1ATT:W2736 BUTT 20FDCLEAR36-42 FSIDES:B S0619 1001-197-559 2.00 EA MI/MI MATCHING INTERIOR OPTION % MI/ATT:W2736 BUTT MI A Y $73.22 $146.44* FSIDES:B S0620 1001-197-559 1.00 EAJ CW2436L/CW2436L CORNER WALL CW2436L/CW2436L FSIDES:B A Y $343.40 $343.40* HINGES:L S0621 1001-197-559 1.00 EA V30 SH/V30 SH SHAKER VALANCE V30 SH/V30 SH FSIDES:B HINGES:L A Y $62.41 $62.41* MODS:W=30" H=5 1/2" D=0 3/4" S0622 1001-197-559 1.00 EA W3012 BUTT/W3012 BUTT WALL CABINET W3012 BUTT/W3012 BUTT A Y $197.68 $197.68* FSIDES:B HINGES:B S0623 1001-197-559 1.00 EA VDO-2SAM/VDO-2SAM VDO WITH 2PC SAM8 MOLDING %VDO/ A Y $19.77 $19.77* ATT:W3012 BUTT VDO-2SAM FSIDES:B S0624 1001-197-559 1.00 EAJ MI/MI MATCHING INTERIOR OPTION% MI/ATT03012 BUTT MI A Y $49.42 $49.42* FSIDES:B S0625 1001-197-559 1.00 EA W3015 BUTT/W3015 BUTT WALL CABINET W3015 BUTT/W3015 BUTT A Y $200.56 $200.56* FSIDES:B HINGES:B S0626 1001-197-559 1.00 EA 20FDCLEAR15-30/20FDCLEAR15-30 TWO OFD CLEAR 15" -30"/ A Y $178.57 $178.57* ATT:W3015 BUTT 20FDCLEARI5-30 FSIDES:B S0627 1001-197-559 1.00 EAJ MI/MI MATCHING INTERIOR OPTION% MI/ATT:W3015 BUTT MI A Y $50.14 $50.14* FSIDES:B S0628 1001-197-559 1.00 EA W3618 X 24 DP B/W3618 X 24 DP BUTT REFRIGERATOR WALL CAB/ A Y $286.41 $286.41 W3618 X 24 DP BUTT FSIDES:B HINGES:B S0629 1001-197-559 1.00 EA BTK8/BTK8 BASE TOE KICK/BTK8 HINGES:L IA Y 1 $14.431 $14.43* ***CONTINUED ON NEXT PAGE*** * Indicates item markdown Page 2 of 3 NO. 2668-427892 Customer Copy SPECIAL SERVICES CUSTOMER INVOICE - Continued Last Name: WALSH Page 3 of 3 NO. 2668-427892 VENDOR DIRECT SHIP #1 (Continued) TO: CUSTOMER S0630 1001-197-559 1.00 EA PUTTYSTICK EXT2/PUTTYSTICK EXT2 PUTTY STICK EXTERIOR QTY/ A Y $7.58 $7.58" PUTTYSTICK EXT2 FSIDES:B HINGES:L S0631 1001-197-559 5.00 EA SM8 WD/SM8 WD SCRIBE MOLDING/SM8 WD FSIDES:B HINGES:L A Y $18.40 $92.00* S0632 1001-197-559 1.00 EA SCM8 WD/SCM8 WD SOFFIT CROWN MOLDING/SCM8 WD HINGES:L A Y $35.35 $35.35* S0633 1001-197-559 1.00 EA TU MARKER EXT 2/TU MARKER EXT 2 TOUCH UP MARKER EXTERIOR/ A Y $13.71 $13.71* TU MARKER EXT 2 FSIDES:B HINGES:L S0634 1001-197-559 1.00 EA APC/APC READING SQUARE W/DFO PAINTED SILK/APC FSIDES:B A Y $0.00 $0.00 HINGES:L S0635 1001-197-559 1.00 EAJ SILK/SILK READING SQUARE W/DFO PAINTED SILK/SILK HINGES:L A Y $0.00 $0.00 S0636 1001-197-559 4.00 EA SCM8WD/SCM8WD SOFFIT CROWN MOLDING SCM8 WD/SCM8WD A Y $35.35 $141.40* FSIDES:B S0637 1001-197-559 3.00 EA BTK8/BTK8 BASE TOE KICK BTK8/BTK8 FSIDES:B A Y $14.43 $43.29* S0638 1001-197-559 1.00 EA SILK/SILK READING SQUARE W/DFO PAINTED SILK/SILK JA Y $0.00 $0.00 S06FR 0000-506-658 1.00 KITCHEN CABINET FREIGHT JA I $250.00 $250.00 VENDOR-SPECIAL INSTRUCTIONS: LINE: AWCHOICE DSTYLE:READING PAINTED W/DFO USTYLE:42MGS WOOD:APC FINISH:SILK DSGNR:KRB650 VENDOR WILL SHIP MDSE TO: Stone Beverly ADDRESS: 17 Halifax St. CITY: NORTH ANDOVER STATE: MA ZIP: 01845 COUNTY: ESSEX SALES TAX RATE: 6.250 ® ® $8 431.23 PHONE: 978 361-5697 ALTERNATE PHONE: 978 902-2659 PAGER: END OF VENDOR DIRECT SHIP TOTAL CHARGES OF ALL MERCHANDISE & SERVICES Policy Id(PI): $8,431.23 A: 90 DAYS DEFAULT POLICY SALES TAX $526.95 TOTAL $8,958.18 BALANCE DUE $0.00 'The Home Depot reserves the right to limit/deny returns. Please see the return policy sign in stores for details.' END OF ORDER No.2668-427892 * Indicates item markdown Page 3 of 3 No. 2668-427892 Customer Copy ------- ---126°'- - --- �, °° °�--- - " °° " - 24"---'I Y 1 - ,x ---30 - 24 27 !- I W1836L ( W3018 �W2436 BUTI W2736 BUTT) CW243 L E I I � -- J-B18L21 4D RAi`JGE.GAS 30- J B�18R BW BSS ? J Walsh Preliminary Kitchen 2668-427892 — \r 978--361-5697 — Cabinet Line: American Woodmark Iv i Wood SpeciesMaple Door Style: Charlottesville II f WJ Finish: Linen Overlay: Full Construction: All Plywood Construction - -� :I Top Melding: scm8 wd Bottom MoldingNone Door Pulls: TBD -- Drawer Pulls: TBD f ---� Countertop Material: TBD '�w � 0) Color: TBD Edge Detail: TBD Backsplash: TBD Sink: TBD W Faucet: TBD I� 1 NOTES: -appliance specifications required prior to finalizing design 0)I C0 -� - t3� -Did not include any interior accessories ' �= except trash cabinets cutlery divider -design has not been site verified or pier Reviewed and is not ready for sale. - - - w All dimensions size designations "This is an original design and must Designed:9/6/2014 given are subject to verification on R ? d not be released or copied unless Printed:9/6/2014 job site and adjustment to fit jobyapplicable fee has been paid or job -71 r* conditions, a' order placed. 90507flb All j Drawing#: I 1N Scale. 126" ,611, 13" 30" 1811 30" 24" 15" 24" -$7" f , SDB30R, II,, 6" 1$" 30" r 36" �11166� W3018 BUTT W1 836R W3036 BUTT CW2436L BWBT18 ;' 1 B36 1 TD 2FWT BUTjf BSS:�� � FAP�,M�E.C�AS. _ Co _ N Walsh Preliminary Kitchen 8-427892 "" u, 978-861-5697 p Cabinet Line: American Woodmark Wood SpeciesMaplem� �' Door Style: Reading Overlay: Full Cn o- G _ Finish: Silk i f 00 Construction: All Plywood Construction � Top Molding: scm8 wd 03 Bottom Moldin done B Door Pulls: TBD Drawer Pulls: TBD N -4 w N Countertop Material: TBD00 Color: TBD o ;� Edge Detail: TBD Backsplash: TBD rn „� , Sink: TBD ` Faucet: TBD �r 00 NOTES: � X -" C� -M - - 0) -appliance specifications required prior to finalizing design n _ -Did not include any interior accessories except trash cabinets cutlery divider m -design has not been site verified or pier C Reviewed and is not ready for sale. co cn cn _ w 0 _ All dimensions size designations UMI This is an original design and must Designed: 1/26/2015 given are subject to verification on s not be released or copied unless Printed: 1/26/2015 job site and adjustment to fit job vm applicable fee has been paid or job conditions. order placed. —..... -...............-............ 90507flb.kit All Drawing#: 1No Scale. 175" 3n 24" 27" 30" 27" 36" 304 i s, _ I i (..BUTT I � .—� W30 II _ 15 LO _ VI/3618 X24 DP BUT W2736 ; BUTT W2736 BUTT `N OW2436L W3012 BUTT )V ' uT _ V30 SH G Cq�' �Y'[A , 31 11 CD j �F� � ,, 1-�� WTE r� f�G�� �f �1 �� s �� , 4 X 90R4ROT _ SK.25-1TUB2 REP. D.I E 1OW3 LJ . w CO LO (0 BSS36L WD - 315 4DV SB30 BUTT DISH-1(DWR:1 B15R III 1 36" 15" 30" 2411 it 36" 15" 151 ' 66" 27" 33;6" _ 48116' All dimensions size designations 11 This is an original design and must Designed: 1/26/2015 given are subject to verification on not be released or copied unless Printed: 1/26/2015 job site and adjustment to fit job ^µ applicable fee has been paid or job conditions. order placed. 90507flb.kit El 2 iDrawing#E: 1 1 No Scale. - 12 " 18#1 30►► 18 30 24►► W3018 BUTT ; I _ W1836R W3036 BUTT CW2436L 01 IW H D L �ItV; LO f BWBTI8.RANGE.GAS.30-1,6 1TD 2FWT BUT', BSS36L WD 18 30" 36" 36'► 15►' 24" 87" All dimensions size designations 6 This is an original design and must Designed: 1/26/2015 given are subject to verification on not be released or copied unless Printed:1/26/2015 job site and adjustment to fit job applicable fee has been paid or job conditions. m order placed. 90507flb.kit 1 El 1 FDra-ing#: 1 No Scale. Existing layout 0 1 New layout 441 y _ _ _ ------------------- -------------------- ------------ 0 4►p►► 6►8 � 0) laundry shelves �O0 3/10/15 16:17:06 ET T0:19706009542 FROM: 9706714514 Merrimdch Vdlley Ins 001 DATE(MMIDDIYYYY) A�EP CERTIFICATE OF LIABILITY INSURANCE 3/10/2015 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). PRODUCER CONTACT Deborah Gilbert NAME: Merrimack Valley Insurance Agency Inc PAHON�E o.EY _ (978) 667-2541 AIC No; (97S)671-4519 655 Boston Road, Suite lA E-MAIL ADDRESS:DGilbert@mvins-Com INSURER(S)AFFORDING COVERAGE NAIC 4 Billerica MA 01821 INSURERA.Main Street American Assurance 29939 INSURED INSURER B WALSH GENERAL CONSTRUCTION INSURER C: 15 MARLYN RD INSURER D INSURER E: BILLERICA MA 01821-1901 INSURER F: COVERAGES CERTIFICATE NUMBER?014 GL 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 LIMITS LTR INSR WVD POLICY NUMBER MMIDD MMIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED S 500,000 X COMMERCIAL GENERAL LIABILITY PREMISES'Ea occurrence A CLAIMS-MADE Q OCCUR T6295N /5/2014 /5/2015 MEDEXP(Anyaneperson) $ 10,000 PERSONAL BADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccldentl S UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- LIM AND EMPLOYERS'LIABILITY — ANY PROPRIETORIPARTNERIEXECUTIVE FNIA E.L.EACH ACCIDENT S OFFICERRUEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ if yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it more space is required) CERTIFICATE HOLDER CANCELLATION 19786889542@sendfax.innopo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of N Andover ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St Bldg 20 Ste 2035 AUTHORIZED REPRESENTATIVE N Andover, MA 01845 Anthony Lucacio/DEBG , ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(9wnn,i ni Th. Amon".mA an.I inn-nrA -f A4r.nPn RightFax C3=1 3/11/2015 8 : 59: 36 -AM PAGE . 2/002 Fax Server "x <: CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D D/YYYY) T. TIFICATE 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 and endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: MERRIMACK VALLEY INS PHONE FAX 655 BOSTON RD.I A (A/C,No,Ext): (A/C,No): E-MAIL BILLERICA,MA 01821 ADDRESS: 73175K INSURER(S)AFFORDING COVERAGE NAIC q INSURED INSURER A: AMERICAN ZURICH INSURANCE COMPANY WALSH,JAMES DBA WALSH GENERAL CONSTRUCTION INSURER B: INSURER C: INSURER D: 15 MARLYN ROAD INSURER E: BILLERICA,MA 01821 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. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MM\DD\YYYY) (MMDD\YYYY) LIMITS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR. PREMISES(Ea occurrence) ED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY ®PROJECT D LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINEDSINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND X WC STATUTORY OTHER EMPLOYER'S LIABILITY YM UB-2E643119-15 01/07/2015 01/07/2016 LIMITS ANY PROPERITOR/PARTNER/EXECUTIVE OFFICEWMEMBER EXCLUDED? N/A E.LEACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR WALSH,JAMES. CERTIFICATE HOLDER CANCELLATION TOWN OF N ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1600 OSGOOD ST,BLDG 20 SUITE 2035 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRU 4. N ANDOVER,MA 01845 ` ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1999-2010 ACORD CORPORATION: All rights reserved. The'Commonwealth of Massachusetts Department of IndustrialAceidents • . Z Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/E lectricians/Plumbers. TO BE FILED'WITH THE PERMITTING AUTHORITY. Applicant Information / Please Print Leaibly Name(Business/Organization/Individual): ll� 'el- U AJ Address: (/ C(. V- r City/State/Zip: .�l1 rte ( Vvl Phone#: 7 ' Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with 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. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 1 Demolition ❑ 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 1 L❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5. I 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.$ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other 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. 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 am art employer tl:at is providing workers'compensation insurance for•my employees. Below is the policy and job site information. Insurance CompanyName: Policy#or Self-ins.Lic.#: ` ✓ F,_,� ) G- G l -3/ / Expiration Date: Q Job Site Address: ' . Z� l h , a e ( City/State/Zip: C)I 7 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 WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c t y u der the pains and penalties o per'ury that information provided abov is true and correct. f Si nature• -" --" Date: 0 107-2 0 Phone# � "` l Official use only. Do not write in this area,to be completed by city or town official.. City or Town: PermitAl icense# Issuing Authority(circle one): ; 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.PIumbing Inspector 6.Other Contact Person: Phone#: i r j 3 d s CS-072199 y/ 15 KARLYN RID. ,";'TLL L TRICK,MA;'01821 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 126909 Type: Office of Consumer Affairs and Business Regulation Expiration: 8/5/2016 DBA 10 Park Plaza-Suite 5170 WALSH GENERAL CONST Boston,MA 02116 JAMES WALSH' 15 MARLYN RD BILLERICA,MA 01821 Undersecretary — g Not valid without sin tnr� —�