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Home My WebLink AboutBuilding Permit # 11/19/2016 OORTH BUILDING PERMIT TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION _ ®„ Permit N : `� ® �' ' Date Received �9 °ffareo pQe 'L� ,� �SsaICPIUS�� Date Issued: IMPORTANT:Applicant must complete all items on this page LOCA 66N a f� Print, :.is PROBE iTY OWNER.; a77 lid, >I%} � . rir►t ; MAF' NO PARCEL: ZONING DISTRICT: Historic District yes ; na Machirie Shop Village ; ya nc�' , TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building AOne family ❑Addition ❑ Two or more family ❑ Industrial Alteration No. of units: I i Commercial epair, replacement ❑Assessory Bldg ❑ Others: V6emolition ❑ Other 11 Septic '❑Well 0 Floodplain ❑Wetlands ❑ Watershed District ❑Water/Sewer Identification Please Type or Print Clearly) OWNER: Name: ' 9 f1,1 P one ,- � �� {,�, � � � --1. i Address: CONTFZACTOR Name: Phone: ( il- \1: ' dress:< YD uMP Su erviaor s Constructibh Lice;se: P Horne Irnprauement License: Exp: Date: ARCH ITECT/ENGI NEE Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:MOO PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. I 11r Total Project Cost: $ � �),-) ` U-- FEE: $ Check No.: 1 �� _Receipt No.: NOTE: Persons contracti;ng ve th unregistered contractors do not have access to theguaranty fund Signature of AgentOwner Signature of contractor' FORTH i own o nctover ® '- .............. No. omU h' verass,q O LAKE l coc"Ic Ml WIclK V aORATED rPA��S S U BOARD OF HEALTH P E T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ............. ... .1 .1_0......... ...1.4i .0........................ . Foundation has permission to erect .......................... build' s on ... .. C...:...... ... .... .......... Rough to be occupied as ..........rccepingl . . ........: .♦............................................................. Chimney Ilk provided that the person thispermit 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 Rough VIOLATION of the Zoning or Building Regulations Voids-this Permit. Final PERMIT EXPIRES IN 6 MOWS ELECTRICAL INSPECTOR LESS CONSTRUCTION fT T Rough Service ... ...... ....................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy ulldinRough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathingor all To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. vV�M1N oc��a o ® o® McCormick Kitchens 1161 Broadway Saugus, MA`61906 (781) 231-4200 Fax (781) 231-4270 www.mccormick-kitchens.com TO: ROBIN COLOMBOSIAN PHONE DATE 9/17/2015 21 ASH STREET JOB NAME/LOCATION NORTH ANDOVER MA 01845 (C) 978 .604.0870 JOB NUMBER JOBPHONE 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: 11.23 .15 I JOB COMPLETION DATE: 01.29.16* *INSPECTIONS/PERMIT SIGN OFFS MAY EFFECT COMPLETION DATE* MCCORMICK KITCHENS TO DEMO EXISTING KITCHEN CABINETRY AND COUNTERTOPS AND PREP FOR NEW. MCCORMICK KITCHENS TO REMOVE EXISTING FLOORING IN EXISTING KITCHEN AREA AND PREP FOR HARDWOOD. MCCORMICK KITCHENS TO INS-rRI,L CG LIQ-iVT -M Pf2<,ViDE ) HARDWOOD FLOORING IN KITCHEN ONLY. CLIENT TO SAND/POLY KITCHEN FLOORING ONCE KITCHEN PROJECT IS COMPLETE. MCCORMICK KITCHENS TO REMOVE EXISTING SOFFIT ABOVE EXISTING CABIENTRY. MCCORMICK KITCHENS TO REMOVE PARTIAL WALL THAT IS COMING DOWN FROM THE CEILING WHERE THE FRIDGE IS LOCATED AND PATCH AS NECESSARY. MCCORMICK KITCHENS TO GO OVER EXISTING CEILING WITH BLUEBOARD AND PLASTER WITH SMOOTH FINISH. CLIENT'S PAINTER RESPONSIBLE FOR PREPPING FOR PAINT AND PAINTING. MCCORMICK KITCHENS TO REMOVE ANY RELATED DEBRIS FROM SITE. MCCORMICK KITCHENS TO PURCHASE, DELIVER AND INSTALL MEDALLION GOLD KITCHEN CABINETS AS DESCRIBED BELOW AND SHOWN ON PRINTS. Cust. Office FM Cust. Office FM MAKE st�F_ t'An-,I✓- D D DOOR WOOD 0 C� STAIN r �] MLDGS. t ACCESS it0 W E P R POS E hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: dollars($ ). Payment to be made as follows: SEE PAYMENT SCHEDULE ON PAGE 3 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 i 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 proposal may b workers are fully covered by Workers Compensation insurance. withdrawn by s if not accept ff it i days. ' V 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: — o ® o® McCormick Kitchens 1161 Broadway Saugus, MA 61906 (781) 231-4200 Fax (781) 231-4270 www.mccormick-kitchens.com TO: ROBIN COLOMBOSIAN PHONE DATE9/17/2015 21 ASH STREET JOB NAME/LOCATION NORTH ANDOVER MA 01845 (C) 978.604.0870 JOB NUMBER JOB PHONE specificationsWe hereby submit PAGE 2/3 MCCORMICK MCCORMICK KITCHENS TO PURCHASE & INSTALL CAMBRIA QUARTZ 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. MCCORMICK KITCHENS INSTALL TILE BACKSPLASH. 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, RELOCATE & RECONNECT SINK, DISHWASHER, FAUCET, RUN WATER LINE TO REFRIGERATOR, & DISCONNECT AND RECONNECT GAS LINE TO 94"CA,i MCCORMICK KITCHENS TO REPLACE EXISTING TOE KICK HEATER WITH A NEW ONE UNDER SINK BASE. ELECTRICAL: MCCORMICK KITCHENS TO WIRE KITCHEN TO CODE. MCCORMICK KITCHENS TO PURCHASE AND INSTALL (7) RECESS LIGHTS, PURCHASE AND INSTALL (6) UNDER CABINET LIGHTS, PURCHASE AND INSTALL (3) INTERIOR CABINET LIGHTS, AND INSTALL PENDANT LIGHTS/FIXTURE(S) ABOVE ISLAND (CLIENT TO PROVIDE) . MCCORMICK KITCHENS TO INSTALL ALL APPLIANCES. OF V E:�- 01000 Cust. Office FM Cust. Office FM MAKE s-e� Pt,�c-e 3 0 0 DOOR s PAC,C_7 0 �� WOOD i F_�j F-1 STAIN MLDGS. 0 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: SEE PAYMENT SCHEDULE ON PAGE 3 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 y I} 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 proposal may b workers are fully covered by Workers Compensation insurance. withdrawn by u �not accepted within days. 4 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: goMcCormick Kitchens 161 Broadway Saugus,, MA 01906 (781) 231-4200 Fax (781),231-4270 www.mccormick-kitchens.com PHONE DATE TO: ROBIN COLOMBOSIAN 9/17/2015 21 ASH STREET JOB NAME/LOCATION NORTH ANDOVER MA 01845 (C) 978.604.0870 JOB NUMBER JOBPHONE specificationsWe hereby submit PAGE 3/3 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. MCCORMICK KITCHENS IS NOT RESPONSIBLE FOR: PURCHASING OF APPLIANCES, HVAC, PURCHASING OF SPECIALTY LIGHTS OR SWITCHES, REMOVING OF WALLPAPER, PAINTING, PURCHASING OF BACKSPLASH, PURCHASING OF SINK OR FAUCET, FINISHING (SANDING/POLY) OF HARDWOOD FLOORING, OR PERMIT FEES. *** ALL PAYMENTS MUST BE RECEIVED IN THE ORDER LISTED BELOW. *** PAYMENT SCHEDULE: $14, 000 DEPOSIT, $8, 000 DUE UPON START, $10, 000 DUE UPON DELIVERY OF CABINETRY TO MCCORMICK KITCHENS, $6, 000 DUE UPON ROUGH ELECTRICAL/PLUMBING, $6, 000 DUE UPON FLOOR INSTALL BEING COMPLETE, $2,500 DUE UPON COUNTER TOP TEMPLATE, $2,500 DUE UPON COUNTER TOP INSTALL, $1,OCO DUE UPON COMPLETION Cost. Office "NMCust. Ot9ice MAKE M0--)ALt,4oQ DOOR_PA'ztc (Ff ) WOOD mAPLv- RC F:--1 DtylNtTy l d ( MLDGS. -tx , P53 D, TRQCP-r,1 F:�l ACCESS WE PROPOSE hereby to furnish material and labor—comalete in accordance with the above specifications,for the sum of: Fifty I(��Sgi\rD i�OLl�Cie 00/100 Dollars dollars($ 50,CX)0.00 ) Payment to be made as follows: SEE PAYMENT SCHEDULE ABOVE 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 proposal may be workers are fully covered by Worker's Compensation insurance. withdrawn bnot cc�pted within days. l ACCEPTANCE OF PROPOSAL —The above prices, y u 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: MAKE rntz6nc41oN DOOR Park- ® l� I �L WOOD rn�� STAM, Dld(NW( Ccns;,t. (�ra,Nr c- Z � MLDGS. Tl-, rl5sb, !1112Qca" ACCESS. CLt-r o;vI)G-Yz- -12"- - .__. 63,"------- 21" 12'=-12' -27351=t`� / ,-3 2§V-24,2 3g�'�e W2136- DW2436 L 11 (`', 24.DISHW S Ln N ctl --- 0 - - MO - - C,) co Qj1p W N OD coo m m co - B36-L ----36 "-- o -- BLnW2 --16 s' 636 - >—VVG�'n7c4253v— .�Vr��L�r 34 _-L 1 - _.-—� C ---� ---- -- N t. (D J M N\ I L- 33i - --� N I F-3 -12"4, 4 CD s Ordered by Ack.n. Ckd b Final ck by FM P i..r:�.uurJ :V�r� .!'J�r ., /�. � iM1:i..s. .,.. ............... ... .. ..... .. � � '� r � G- ' �_ jj�� l �1 u! _ � ` %� ® DATE(MMIDDIYYYY) AC"R" CERTIFICATE OF LIABILITY INSURANCE 5/28/2015 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(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Amanda SCLiCOS NAME: TGA Cross Insurance, Inc. aCNN,Ext): (781)914-1000 INC No):(701)224-5777 401 Edgewater Place ADDRESS:astricos@tgacross.com Shite 220 ---INSURER(S)AFFORDING COVERAGE NAIC 0 Wakefield MA 01880 INSURERA:Employers Mutual Ins Co INSURED INSURER S:Hartford Accident and Indemnity Co '22357 McCormick Kitchens Inc. INSURERC: -----4 1161 Broadway INSURER D INSURER E: Saugus MA 01906 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1551538572 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 -- - _-- - - 'ADDL I POLICY EFF POLICY EXP - -- - _ -_--- - LTR TYPE OF INSURANCE SUDRI POLICY NUMBER MMlD D LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 i DAMAGE TORENTEb —---- A CLAIMS-MADE X OCCUR PREMISES(Es occurrence) $ 100,000 5230150 5/1/2015 5/1/2016 MED FXP(Any one person) $ 5,000 ! PERSONAL B ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE :$ 2,000,000 I. POLICY PRO- LOC ! PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBIN I $ I,000,000 C (Ea accident) _ A ANY AUTO BODILY INJURY(Per person)—S ALL OWNED SCHEDULED AUTOS AUTOS 5230150 5/1/2015 5/1/2016 BODILY INJURY(Per accident) S I-X HIRED AUTOS �AUU 108 F� -(I er�Rd DA61AGE -.- $ X $ X UMBRELLA UAB ; ,OCCUR i EACH OCCURRENCE $ 1,000,000 A EXCESS UAB CLAIMS-MADE! I AGGREGATE $ 1,000,000 DED X 1RETENTIONE Oi 5J30150 5/1/2015 i 5/1/2016 $ WORKERS COMPENSATION i I PER DTH- 'AND EMPLOYERS'LIABNJTYY/N, STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVEOFFIC - N/A E.L.EACH ACGDENi E 1,000,000 B (Maria ctuyin H)E%CLUDED7 OMC2557MR02 5/1/2015 5/1/2016 (Mandatory in NH) E.L.DISEASE-FA EMPLOYEES 1,000,000 If yes,de$V tinder IDE RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 '.. i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE J/_ Thomas Gregory/SP3 -�—V�IL U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov1dia Workers'Compensation Insurance Affidavit:Builders/Contractors/lileetricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information f/ Please Print Legibly Name(Business/Organization/Individual): Address: t City/State/Zip: �` ' ( 11,J M, P7 Phone#: ;' ,N J Are you-at,employer?Chech ppropriate box: Type of project(required): 1.�a employer with f`'� employees(full and/or part-time).* 7. ❑Ne construction 2.Q I am a sole proprietor or partnership and have no employees working for me in $ modeling any capacity.[No workers'comp.insurance required.] 9. Demolition IF]I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10[(Building addition 4.0 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 l l.ElYlectrical repairs or additions proprietors with no employees. 12.[Wumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q 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. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp_policy number. I arts art employer that is providing worliers'contpettsation insurance for rtty employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.# SS Expiration Date: Job Site Address: City/State/Zip: p LIN- 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 e. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORD ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DTA for insurance coverage verification I do hereby ce tifyd t1thepains alt-enalties of perjury that the information provitled above is trite d correct. Signature: Date: Phone#• UJ ( � Official use only. Do not sprite 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 5.Plumbing Inspector 6.Other Contact Person: Phone#: Q '"%�r �-r rn�nr.nrrn•rr�/�r ' ��r.:.;rrr�rr�r//; _ \ Office of Consumer Affairs& Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: �Ilegistration: 131725 Type: Office of Consumer Affairs and Business Regulation l`xpiration: 9/6/2016 Private Corporatio., 10 Park Plaza-Suite 5170 ' Boston,MA 02116 McCORMICK BUILDERS GROUP, INC. FRANCIS McCORMICK JR. 1161 BROADWAY44it&ut SAUGUS,MA 01906Uudersecreta'7' Not signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards CuniirUiiiun SLiP eiZ'iwr License: CS-051304 FRANCIS MCCO�YII 1161 BROADWAY � ¢ ROUTEISOUTH Saugus MA 01906b y \` Expiration € Commissioner 01/05/2017