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4B SPRUANCE WAY - BUILDING INSPECTION (4) (Poo The Commonwealth of Massachusetts W Board of Building Regulations and Standards CITY OF Massachusetts State Building Code,780 CMR SALEM Revised Mar 2011 Building Permit App)katton.,To Construct,Repair,Renovate Or Demolish a One-!)Two-Family Dwelling s Section For Official Use Only Building Permit Number: Date lied: C3 Z—t I—I y Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATION 1.1 P opert Address: 1.2 Assessors Map& Parcel Numbers , VVOAAVi p Wo-o I.1a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Check if yes❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2. caner'of Recor Name(Print) City,State,ZIP ' No.and Streit Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply)' New Construction❑ Existing Building EriOwner-Occupied WJ Repairs(s) ❑ 1 Alteration(s) MI Addition ❑ Demolition 91Accessory Bldg. ❑ 1 Number of Units_ Other ❑ Specify: Brief pescrip can of Proposed Work2: Q i L°�-1 Kydg lv��ji�i,AfM i /1 d yU A J—' ('G bine S + ('v(,4 L-kt�al . GJ1Y� SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Labor and Materials) Official Use Only 1.Building $ a 3 p r ES—D.O 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical - $ ❑Standard City/Town Application Fee 00'(22 ❑Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List 5.Mechanical (Fire $ Suppression) Total All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 5�� ❑Paid in Full ❑Outstanding Balance Due: (` CoC-Mr-\cj�- Vow Ov `l ) SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) aYM ( L J r• License Number Expi tion ate Name of CSL Holder 1 Lei B tprnj y-*(J List CSL Type(see below) No.and Street Type Description ✓ d 14 / U Unrestricted(Buildings u to 35,000 cu.ft. (I '"I 40 R Restricted 1&2 FamilyDwelling City/To Mate,ZIP M Mason ry t RC RoofingCovering WS Window and Siding / SF Solid Fuel Burning Appliances / I d31-Nl fJ�CrD✓Mirk-_ki ��P/'t) o�t�Giitti•(7•j I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC)M-04a44-ism i3l _ Y C-�3-ln n��. Gk.. HIC Registration Number y/xpvation Date HIC Comp and Street.❑y N r e or C Registrant ne j f/• 11 d �/ copmicl� Ki+Ckotas�/Glay. r� uu' 777 ���� 178k)31-N2 Email address Ci / State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... No...........❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize �� �� U h U$ M r l y/0 id JY to act on my behalf,in all matters relative to work authorized by this building permit application. X v�1 S i ti Print Own is Name(EFectronic Si t ture) G/ �. ate SECTION 7h,OWNER' R AUTHORIZED AGENT DECLARATION By ent ring rry name below,I hereby attest under the pains and penalties of perjury that all of the information contai ed 'n this application is true and accurate to the best of my knowledge and understanding. Pli' 'Owners r Authorized Agent's Name(Electronic Signature) yGt rl Ul C� ;L Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.eov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF S 1I.E:�1, 1LNSS.ICHUSETTS ' BU11 DIING DEPARTNIENT 130 WASHINGTON STREET, 3'°FLOOR TEL (978) 745-9595 FAX(978) 740-9846 Kl*,IBERLEY DRISCOLL MAYOR TitomAs ST.Pwmm DIRECTOR OF PUBLIC PROPERTY/BUUMING COMNOSSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit # is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111, S 150A. The debris will �b)�e�transported by: �y (06/* (name of hauler) The debris will be disposed of in ILIA atp'e/k J 0 i - (name of facility) (address of facility) sign ture of permit applicant date JcbrisafT.doc CITY OF S.U1 EN NIASSACHUSETTS BUILDLNG DEPART%CLNT • 120 WASHINGTON STREET,3w FLOOR TEL (978)745-9595 FAX(978) 740-9846 1CINIBERLEY DRISCOLL IMAYOR THOAIAS ST.Mmits DIRECTOR OF PUBLIC PROPERTY/BUILDING CO%L%USSIONF-R Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Annlicant Information ) / / Please Print Legibly ga Name(BusimssOrnizati0nIndividual):_ L�"(O'( IL'a Address: 1 p City/State/Zip: i4 /9 0 6 Phone#: 20-d-51-M)o Are yoy an employer?Check a appropriate box: Type of project(required): 1. 1 am a employer with 4. 0 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sulaconnactom -� 2.0 1 am a sole proprietor or partner- listed on the attached sheet.: 7• LEI Remodeling ship and have no employees These sub-contractors have 8. MIle-molition working for mein any capacity, workers'comp.insurance. q, Building addition (No workers'comp.insurance 5. 0 We are a corporation and its required.) officers have exercised their 10.62'1�lectrieal repairs or additions 3.0 1 am a homeowner doing all work right of exemption per MGL I I.©numbing repairs or additions myself.[No workers'comp. c. 152,§I(4),and we have no 12.0 Roof repairs insurance required.]t employees.[No workers' 13.0 Other comp. insurance required.] ;Any applicant that checks box#1 most also fill out the section,below showing their workers'wmpentevion policy information. I Iomeuwxva who submit this affidavit indicating they are doing all wont and then hire onside contrecom most submit a new affidavit indicating such =Commurs,that check this box meat attached an additional sheet showing the name of the sub•mntmc m and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below Is the palley and Job site information. � Insurance Company Name: Lb I-/6 / n Policy#or Self-ins.Lif�c,#: D D Q l a C), ,� 1 Expiration Date; ( ��/2(DI`fp n Job Site Address: 4 60rua n cei W(;{�{� City/State/Zip:ddimf///� Q�/ / Attach a copy of the workers'compensation policy d6aration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the Corm of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. /do hereby certl del rhr pulps and penalties of perjury tha!the injurmutlan provided above is true and correct. /— D t Ir • a 0 _ P a #• I-O L: 2vo Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/I,Icense# Issuing Authority(circle one): 1. Board of Ilerith 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: __ Phone#: Massachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supercmur License: CS-051304 FRANCISMCCO$MI "' r 1161 BROADWAY ' c ROUTEISOUTH Saugus MA 019061, Expiration 01105/2015 Commissioner Unrestricted - Buildings of anv use group which contain less than 35,000 cubic feet(991tn3)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS ('T r �/-�,ncrirc,irraru�Itt O,n;��/d;ac✓irJelll Office of Consumer Affairs&Business Regulation V'ME IMPROVEMENT CONTRACTOR egistration: 131725TYPe: piration: 9l6/2014 Private Corporation McCORMICK BUILDERS GROUP,INC. FRANCIS McCORMICK A. 1161 BROADWAY ROUTE 1 SOU §XUGUS,MA 01906 Undersecretary License or registration valid for individul use only before the expiration date. 1f found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 _. ----- Not vali w hoot signature I e ® o® McCormick Kitchens _ �' • 1161 Broadway Saugus, MA 01906 (781) 231-4200 Fax (781):231-4270 www.mccormick-kitchent.com TO: STACEY SCHARF PHONE once 12/26/2013 4B SPRUANCE WAY JOB NAME LOCATION SALEM MA 01970 (C) 3fd1 52 3 G (W) 978.816.0557 JOB NUMBER JOB PHONE PAGE 1/3 _ „... ,.. JOB START DATE: 02. 17.14 1 JOB COMPLETION DATE: 04 .02. 14 *INSPECTIONS/PERMIT SIGN OFFS MAY EFFECT COMPLETION DATE* MCCORMICK KITCHENS IS FULLY LICENSED AND INSURED: COMMONWEALTH OF MASSACHUSETTS HOME IMPROVEMENT CONTRACTOR REGISTRATION #: 131725 MASSACHUSETTS DEPARTMENT OF PUBLIC SAFETY LICENSE NUMBER: 51304 MCCORMICK KITCHENS TO DEMO CURRENT KITCHEN CABINETS & COUNTERTOPS AND PREP FOR NEW. MCCORMICK KITCHENS TO PATCH EXISTING KITCHEN WALLS WHERE CABINETRY IS TO BE LOCATED AS NECESSARY. MCCORMICK KITCHENS TO REMOVE ALL DEBRIS FROM SITE. MCCORMICK KITCHENS TO PURCHASE, DELIVER AND INSTALL MEDALLION DESIGNER KITCHEN CABINETS AS DESCRIBED BELOW AND SHOWN ON PRINTS. MCCORMICK KITCHENS TO PURCHASE AND INSTALL GROUP 1 GRANITE COUNTERTOP WITH ONE OF THE (4) STANDARD NON—UPCHARGE EDGES NOTED IN CONTRACT PACKAGE. IF STONE/COUNTERTOP MATERIAL (OR) EDGE IS UPGRADED, ADDITIONAL CHARGES WILL APPLY. MCCORMICK KITCHENS TO INSTALL TILE BACKSPLASH. COST TO BE PASSED ON TO CLIENT ONCE INSTALL IS COMPLETE AND IS NOT INCLUDED IN CONTRACT TOTAL. BACKSPLASH INSTALLATION COST RANGES FROM $500—$1000, DEPENDING ON COMPLEXITY) . ALL TILE BACKSPLASH MATERIALS TO BE PROVIDED BY CLIENT AND ARE TO BE ON SITE WHEN COUNTERTOP IS INSTALLED. Cust. Office FM MAKE So` PAG = 3 O Cult Office FM DOOR_ Sty WOOD O STAIN MLDGS. 0 ACCESS WE PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: ). Payment to be made as follows: dollars is SEE PAGE 3 All material is guaranteed to be as specified.All work to be completed in a professional 1 manner according to standard practices.Any alteration or deviation from above specifications Authorized MvOlving Wra costs will be executed only upon written orders,and will become an extra Signature 12- Z 6 f charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Omer to carry fire,tornado,and other necessary insurance.Our Note:This proposal may workers are fully covered by Workers Compensation insurance. withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL—The above prices, /2—/2F// specifications and conditions are satisfactory and are hereby accepted. You are Signature ytiliCN_T_—( authorized to do the work as specified.Payment will be made as outlined above. Date of Acceptance: Signature u ® McCormick Kitchens ® 0 ® 1161 Broadway Saugus, MA 01906 (781) 231-4200 Fax (781)231-4270 www.mccormick-kitchent.com TO: STACEY SCHARF FJOB DATE 12/26/2013 4B SPRUANCE WAY ME/LOCATIONSALEM MA 01970 (C) 7 .52Gr. o(W) 978.816.0557 MBER JOB PHONE PAGE 2/3 7 7 .. _ FLOORING: CLIENT'S EXISTING TILE FLOOR TO REMAIN. MCCORMICK KITCHENS TO PATCH FLOORINGWHERE APPLICABLE (AND AS NECESSARY) . CLIENT TO PROVIDE EXTRA TILES. MCCORMICK KITCHENS TO INSTALL PLYWOOD UNDER CABINETRY WHERE TILE WILL NOT BE INSTALLED TO KEEP FLOORING HEIGHT CONSISTENT UNDER CABINETRY. ELECTRICAL: MCCORMICK KITCHENS TO WIRE KITCHEN TO CODE. MCCORMICK KITCHENS TO PURCHASE AND INSTALL (4) RECESS LIGHTS, INSTALL (2) PENDANT LIGHTS ABOVE ISLr-)N O , AND ADJUST EXISTING CABLE FOR TV AS NECESSARY (CONSULT WITH CLIENT PRIOR TO ADJUSTMENT BEING MADE REGARDING IT'S LOCATION) . MCCORMICK KITCHENS TO INSTALL ALL APPLIANCES. PLUMBING: MCCORMICK KITCHENS TO PLUMB KITCHEN TO CODE, DISCONNECT & RECONNECT SINK, FAUCET, DISHWASHER, DISPOSAL, & RUN WATER LINE TO REFRIGERATOR (IF APPLICABLE) . MCCORMICK KITCHENS TO PROVIDE (1) FREE STAINLESS STEEL UNDERMOUNT AMERISINK AS103 SINK, AND FREE BRUSH NICKEL STOCK KNOBS. IF CLIENT OPTS FOR DIFFERENT SINK OR KNOBS, ADDITIONAL CHARGES TO APPLY. Cust. Office FM Cust. Office FM MAKE st nncc 3 DOOR s� PAUt 3 WOOD STAIN MLDGS. " O 0 ACCESS O 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 PAGE 3 All material is guaranteed to be as specified.All work to be completed in a prolessional 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 antra Signature y 2 2b f 3 charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyondour control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal ay b workers are fully covered by Workers Compensation insurance. withdrawn by us it not accepte within 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. Date of Acceptance: Signature I n ® McCormick Kitchens ® � ® 1161 Broadway Saugus, MA 01906 (781) 231-4200 Fax (781) 231-4270 www.mccormick-kitch46ns.com TO: STACEY SCHARF FJOB E DATE 9B SPRUANCE WAY 12/26/2013 SALEM MA 01970 AME/LOCATION (C) 3e(. S Z(a, p.c 3(0 (W) 978.816.0557 JOB NUMBER JOB PHONE �....,•.,•n..rr-rnrrsTmcr-rrn•m�rrnl•nnn_ i PAGE 3/3 MCCORMICK KITCHENS IS NOT RESPONSIBLE FOR: PURCHASING OF APPLIANCES, PURCHASING OF SPECIALTY LIGHTS OR SWITCHES, PURCHASING OF PENDANT LIGHTS, REMOVING OF WALLPAPER, PAINTING, PURCHASING OR INSTALLATION OF BACKSPLASH OR PURCHASING OF FLOOR TILES, PURCHASING OR FAUCET, SINK, HARDWARE OR PERMIT FEES; OR pu Qc Gr use�iN Srsrcc. a' u6"VOC'Z �ggLr6rt7.S *** ALL PAYMENTS MUST BE RECEIVED IN THE ORDER LISTED BELOW. *** Cust. Office F Cust. Office F MAKE m Unwov DEStC4vE1Z 0 DOOR WOOD mrrP N fITL fCEN CL115$fL STAfN PA,nT ALDGS.TIe K p 5rtKtV� ACCESS ruo- Cyr awe mcn w s�fr -_. c' c. cr-a.N� 4ra4 r, WE PROPOSE hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: Twenty Eight Thousand Five Hundred and 00/100 Dollars Payment to be made as follows: 2369 fl/za1,3 dollars($ 28, 500.00 ). .�8, 500 DEPOSIT FOR RENDERINGS $8, 500 DUE UPON DELIVERY OF CABINETRY TO MCCORMICK KITCHENS, $9, 000 DUE UPON ROUGH ELECTRICAL/PLUMBING, $3, 250 DUE UPON COUNTER TOP TEMPLATE, $3,250 DUE UPON COUNTER TOP INSTALL, $1, 000 DUE UPON COMPLETION All material is guaranteed to be as specified.All work to be completed in a professional manner according to soridard practices.Any alteration or deviation from above speoficafions AuthodZ ed involving extra costs will be executed only upon written orders.and will become an extra Si charge over and above the estimate.All agreements contingent 12, 2- delays beyond our control.Owner to carry fire,tornado,and other neceessa insumnce.tOur Signature workers am fully covered by Worker's Compensation insurance. ry Note:This proposal may be withdrawn by us if not accepted within 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 matte as outlined above. Date of Acceptance: Signature -MAKE f112pl4om oeSlGnt]Z DOOR lffteW a"co-- OOD Y17APr.E- � tJ e-,1A C-te- S�'-AfN Gc¢[55fC" Pmr� Fi1u 734re._rnsnov, MLUGS 7K, F'SSJ SNj l ACCESOSS - � I 150--" 9" 36" 27"—, 30" 27"' 21" 27" 60; fi3„ 9" 3 ' 27 3 12„� 6„ WLS2718 y WL 271 DW2136-� M V 3"w 1 O 24W36186,.01. 3D627 - �' „rt7, C12 T ,q `� rn Ln 37 OD ry \i I Ey4A tl 133613'ef w 9a ED iI N a eh i 6" 14 �12 "II= 9 F 'h I 26„ �. �I^ I � o -42' BERM o / �~ i f 85s" 131-" 217;--" y All dimensions size7designations7P1•]O This is an on inal desi n and must Designed: 12/21/2013OrdcredbLV L g g e subject to lireeeleCICS not be released or copied unlessPrinted: 12/26/2013 Adcn. Ckd by job site and adjustme applicable fee has been paid or job Final d.by FM ons. order placed. 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Note: This drawing is an artistic 2020� Designed: 12/21/2013 interpretation of the general TECHNOLOGIES Printed: 12/26/2013 appearance of the design. It is not meant to be an exact rendition. Scharf final :: All Drawing #: I 2ooF 0 _ - o n i ®®a 1 I ve�ame®s o i - r 2Lt , Wire \� 1 V"?P-&V-- �nlst �N, t ? vp�OL W� R��D 12izonrM l. GL.t1�S Note: This drawing is an artistic � 20 Designed: 12/21/2013 interpretation of the general 20 Printed: 12/26/2013 appearance of the design. It is TEC not meant to be an exact rendition. Scharf final All Drawing #: 1 r - 1 i it I � I ii I + I e e e I ' I Note: This drawing is an artistic ZO ®EU Designed: 12/21/2013 interpretation of the general TECHNOLOGIES(� Printed: 12/26/2013 appearance of the design. It is not meant to be an exact rendition. scharf final All Drawing#: 1