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HomeMy WebLinkAboutBuilding Permit # 8/27/2015 F OORTP �... BUILDINGIT ��Rqd�° �B� TOWN OF -_NORTH APPLICATION FOR PLAN EXAMINATION Permit o �, Date Received SSAC SBUS Date Issued=-� IMPORTANT: Applicant must com Tete all items on this page LOCAT ICON PRQPE4TY'®UIfNER`' '.PIr t y MAP',NARCL: I zONliuGll�TRIT: Historic Distrit no Malin Shep.Village no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential i New Building b One family ❑A dition 11Two or more family 11 Industrial Iteration No. of units: i I Commercial Flpair, replacement ❑Assessory Bldg ❑ Others: emolition ❑ Other ❑Septic Ca Well D Floodplain ' ❑Wetlands ❑ Watershed District' ❑'1Nater/Sewer i F ) x "4 1, U I/v an cl(--" t r j Identification Please'Type or Paint Clearly) OWNER: Name: ga- "` vP� r�� . /qe# Phone:JJ t Address: � ,CONTRACTOR ,Name: nai �` _,:w�� Phone: Address: taprvior'� Ccartrctiora. Licerle: Exp. "Date- Herne Irnnro�rerneht Liderts :: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF TIME TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �Z� � FEE: � " 6 c Check No.: C Receipt No.: 1 --c-1 'p NOTE: Persons contracting unregistered contractors do not have access to t) 'guaranty fund Signature o Ager Owner Signature of contractor F V%®RTH Olk v cAr% r Ut lict A ® - fi • ]( C, Y O LAI(Q h " ver' �.SS i COC NICHT WICK y1. A°RAreo 5 S U BOARD OF HEALTH PER � � IT T U Food/Kitchen Septic System _ l THIS CERTIFIES THAT ....... A ;4�• , �r � tiAA ��� �l BUILDING INSPECTOR ..................... . .............. . ............ ......................................... has permission to'erect .......................... buildings on l) P...... A ................ Foundation JRA 7. at)........................................................ Rough to be occupied as ............... ...l. .. ....... ...... ..� 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 E I E IN S6THS ELECTRICAL INSPECTOR LESS CT Rough Service ............. ...... ...................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Islay 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. M M, 9® v® McCormick Kitchens 7 i 1 G 1 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 J08 PHONE herebyWe • specifications 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. Oust. Office. FM Cult. Office FM MAKE Sri PAC, DOOR SCi�_ PAGE WOOD STAIN VILDGS. r` ACCESS �] 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 S(2 15 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 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, 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: a ® o® McCormick Kitchens 1161 Broadway Saugus, MA 01906 (781) 231-4200 Fax (781) 231-4270 www.mccormick-kitchens.com PHONE DATE 5/1/2015 TO: SCOTT HAJJAR & LINDA JALBERT 176 KARA DRIVE JOB NAME/LOCATION NORTH ANDOVER MA 01845 (C) 978.618.0932 - SCOTT (C) 978.390.3345 - LINDA JOB NUMBER JOB PHONE herebyWe • specifications PAGE 2/3 IF CLIENT OPTS TO HAVE MCCORMICK KITCHENS INSTALL TILE BACKSPLASH, COST TO BE BETWEEN $750-$1, 000, DEPENDING ON COMPLEXITY OF DESIGN. COST IS NOT INCLUDED IN CONTRACT TOTAL. ALL TILE BACKSPLASH MATERIALS TO BE PROVIDED BY CLIENT AND ARE TO BE ON SITE WHEN COUNTERTOP IS INSTALLED. PLUMBING: MCCORMICK KITCHENS TO PLUMB KITCHEN TO CODE. MCCORMICK KITCHENS TO DISCONNECT & RECONNECT SINK, DISHWASHER, FAUCET, RUN WATER LINE TO REFRIGERATOR (IF APPLICABLE) , AND CONNECT GAS (OR) PROPANE LINE TO RANGETOP. ELECTRICAL: MCCORMICK KITCHENS TO WIRE KITCHEN TO CODE. MCCORMICK KITCHENS TO PURCHASE AND INSTALL (4) UNDER CABINET LIGHTS, AND INSTALL PENDANT LIGHTS/FIXTURE(S) ABOVE ISLAND (CLIENT TO PROVIDE) . MCCORMICK KITCHENS TO INSTALL ALL APPLIANCES, INCLUDING VENTING OF THE HOOD AND PATCHING THE EXTERIOR AS NECESSARY. (3) LIG'+T7S fNCL�ua�. MCCORMICK KITCHENS TO PROVIDE (1) FREE STAINLESS STEEL UNDERMOUNT AMERISINK AS125 SINK, AND FREE BRUSH NICKEL STOCK KNOBS. IF CLIENT OPTS FOR DIFFERENT SINK OR KNOBS, ADDITIONAL CHARGES TO APPLY. Cust. Oltice FM Cust. Office FM MAKE 5c:_:-U PA6v_:� DOOR, �� 0 WOOD 0 C_] STAIN MLDGS. 0 ACCESS 0 WE PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: dollars($ ) 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:This ropo I ma be workers are fully covered by Worker's Compensation insurance. withdrawn by us if t cc ted n days. ACCEPTANCE OF PROPOSAL—The above prices, 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: go McCormick Kitchens 1161 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 00 0 DEPOSIT,, 313ojIS -it S30 12, DUE UPON SIGNING OF CONTRACT,S(�o�15 �'S_-3-1 $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, $3,468 DUE UPON COMPLETION l IF C.W er,TV UMTS 1�01L &nt NDMZc, l�Airy --D f'c im�'tra2 CNc; �'1{S-(UY�\ C-i��c�iZ- PIZ-C61(ZAyVX J ClZ E�b1T 7-0 t;t 1 S S 4t ED IN T1't� A?M oU Nt—o F W tS,-i2r Ctr�aLa� I.t. Office. F Cus , Office F MAKEr'Y�f 1�F��c,or.� Coy �� DOOR Pt1'rmrsr�'i. {BLAND � ROOD mRe Lc �t++ r2y STAIN c,siLr tF�ec- vILDGS. , DCmB P, DEE) ACCESS -nu 6OWN 111N'/ �c„T WE PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: Sixty Five Thousand Four Hundred Sixty Eight and 00/100 Dollars dollars($ 65,468.00 �. Payment to be made as follows: St=-�: ���rlvlrrlvT SCa-f��utvL A`L� 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 Worker's Compensation insurance. withdrawn by us if not d thin days. ACCEPTANCE OF PROPOSAL—The above prices, S J 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: ..n :, ----- — --120,'--- -- -- 1o,/--25" 7=--0--� U `n> 7 18 �-24" 2411-41-27"-4' -330 Crd � -25 _�29 . 25a„ K I --- --231'E—L- --- -72' 3 L 126 "-- - -- --- 18" --30' 18' 21 3 II36 1 K12 I W21MB wzrsee Dwz�a2 L 'FT jq�, 81 24W30126 24W1818- i WHO DE423 .7 -4 O w _ 3DBSCR„ DC12 -�I _ — c F I IIT \/I III am ai T 9-R BW24LD D 48 - t Ol' IOIII✓J a mOw I CO/) m A N p II > o e Ib� 03 -d I f� 1 _ II U I y cN T, _ C X '9 24lV —�—� —1604-39 3 !� 24" - - - --- est n 0 - - , . Phis is an original design and mus All dimensions size designations rint 2 5 2O given are subject to verification on I TecHNcirc es not be released or copied unless applicable fee has been paid or job job site and adjustment to fit job conditions. order placed. cc -- -- - -- -- haljar_appt_032815_likes_050215 All Drawing#: 1 Calc /4" = i � o Note: is erpretation of the igenerartistic --- - �/"� 4 '}. g — Cct�(t G V Designed: ECHNOLOGIESPrinted. 5/1/2015 appearance of the design. 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S1 vl✓S not meant to be an exact rendition. i hajjar_appt_032815_likes_050215 All Drawing #: 1 The Comrnonlvealth ofillassacluisetis = T3epar inent of Indusirial Accidents Office of Investigations 600 Rashbigton Street Baston, MA 021.71 wwWanass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electrieians(Plumbers Applicant Information Please Print Le ibl diidal): Kd Name(BusinesOrgauizatiou/In > ' (` Address: State/Zi V / Phone#: City! p• Arc v u au employer? CI►cck the appropriate box: Type of project(required): 1. I am a employer with ._ _ '1 ❑ I am a general contractor and I 6 ❑New construction employees(full and/or parttime).* have hired the sub-contractors listed on the attached sheet, 7. [,remodeling 2.F1 am a sole proprietor or partner- These sub-contractors have g, [�wolitiou ship and have no employees employees and have workers' Building working for me in any capacity. 9• ❑ g addition. comp.insurance.k No workers' co insurance 10. 1 ctrical re airs or additions zequired.] � 5• [�] We are a corporation and its p a a homeowner doing all work of wors have exercised their 11. Plumbing repairs or additions 3 ❑ right of exemption per MCL 12.©Roof repairs myself.[No workers' comp. insurance acquired.]fi c. 152,§1(4),and we have no 13.0 Other ' employees. [No workers' comp.insurance required.] *An applicant that checks box Al must also fill out the section below showing their workers'compensalian policy information. t Homeowners who submit this affidavit indiuiling they are doing all work and then hire outside contmetno 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-contrnctors Bave employees,they must provide their workers'comp.policy number. I ant art employer that is providing tvor'Icers'eorrrpensation insurance for uty employees. Below is thepolicy and job site information. Insurance Company Name: � f Policy#or Self-ins.I.ic.#: V , 2 5 Expiration Dat f� Job Site Address �` / ` City/State/Zip: Al o --, .41—.1-1- -_,. Att-_ cli-a copy o te tvorlters—compensation-policy-deeiaranon page(showing-the policy-uuntUcc azld-cxpirutiura date Fuilure 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.OIMER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations ofth D for insurance Covera e verification. I do hereby certif r f,d r the paints and penalties of per jiny that the information provided above is true ar:d correct Date: �_A i atu Phone Official rise only. Do not write in this area, to be completed by city or town official City or Town- Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: �g ®CC:)RD) CERTI I LIABILITY ' ' ' [:f8/26/2015 (MM/DD/YYYY) f-� 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). CONTACT PRODUCER TGA Cross Insurance, Inc. NAME:: TGA Cross Insurance,Inc. 401 Edgewater Place, Suite 220 HOA�CNE. 781-914-1000 FAAIC No): 781-246-2601 Wakefield, MA 01880 E-MAIL ADDRESS: svVitchboard@tgacross.com INSURERS AFFORDING COVERAGE MAIC# www.tgacross.com INSURERA: Employers Mutual Insurance Co. INSURED INSURER B: Hartford Accident and Indemnity Co. 22357 McCormick Kitchens Inc. 1161 Broadway INSURER C: Saugus MA 0906 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. INSRTYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR 11 SD D POLICY NUMBER MMIDDIYYYY MMIDD/YYYY A COMMERCIAL GENERAL LIABILITY 5D30150 5/1/2015 5/1/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE CLAIMS-MADE ❑✓ OCCUR PREM SESEa oocu D nce $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL BADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY F ECO-- � LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 5230150 5/1/2015 5/1/2016 Ee aBcideDISINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS ✓ HIRED AUTOS �/ NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ A �/ UMBRELLA LIAB OCCUR 5J30150 5/1/2015 5/1/2016 EACH OCCURRENCE $ 1,000000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED ✓ RETENTION$O $ B WORKERS COMPENSATION 08WEC2557MN02 5/1/2015 5/1/2016 ,/ SPERJ TATUTE I EERH AND EMPLOYERS'LIABILITY — Y/N ANY PROPRIETOR/PARTNER/EXECU I NE ❑ N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (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/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Evidence of Insurance for Operations Usual to the Named Insured CERTIFICATE HOLDER CANCELLATION Town of North Andover SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 120 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. North Andover MA 01845 AUTHORIZED REPRESENTATIVE Thomas I Grego ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014//01) The ACORD name and logo are registered marks of ACORD 26119461 1 303078 1 61aster Certificate I Amanda Stricos 1 8/26/2015 11:57:41 AM (EDT) I Page 1 of 1 /�/• I///III r'////'I'(//��l: r///.:.il/r'�I/i/'��i � License or registration valid for individul use only Office of Consumer Affairs& Business Regulation before the expiration date. if found return to: OME IMPROVEMENT CONTRACTOR T e: Office of Consumer Affairs and Business Regulation ,. F�egistration: 131725 Type: 10 Park Plaza-Suite 5170 ,expiration: 9/6/2016 Private Corporatio �•::. Boston,MA 02116 MCCORMICK BUILDERS GROUP,INC. FRANCIS McCORMICK JR. 1161 BROADWAY SAUGUS,MA 01906 Undersecretary Not v ithout signature Massachusetts - Department of Public Safety Board of Building Regulations and Standards -.it llSirUCiiiin Si3PCn i,ir License: CS-051304 FRANCIS MCCO;OKI , 1161 BROADWAY 711F /r= ROUTE 1 SOUTH Saugus MA 01906, 1� iI W O Expiration Commissioner 01/05/2017