6 SUNSET RD - BUILDING INSPECTION r
--- I'Ile C'onunonweahh of Massachusclts
Board of Building Regulations and Standards C-I'I'Y OF
Massachusetts Slate Building Code, 7SO CNIR
Building Permit Applicalion TO Construct. Repair. Renovate Or Demolish u
One-ur Tito-b1unill•Un,ellisl•,,
This Section For Official Lhc Onl
Building Permit Number. D t Apph d:
C0 S
limiding Official(Print Nmune) Slgna Date
SECTION is SITE INFORhIATI
1.1 Property Address: 1.2 Assessurs flap& Parcel Numbers
6 SuziSe4 kd Salo Met,_
I.la Is this an acre fed street? es no Slap Nunther Purcel Numlxr
I•J Zonlny Information: 1.4 Property Dimensions:
Lnning District Proposed(law Lot Area IN 11) Frontage(II)
I.! Bulidlny Setbacks(R)
Front Yard Side Yanls Rear Yard
Required Provided Required Provided Required Provided
1.6 Water Supply:IM.G.I.c.40.154) 1.7 Flood Zone Informations I.lI Sewage Disposal System:
Public Prfvute❑ zone: _ outside Flood Zune?
Check if es❑ Municipd C3�n site disposal system ❑
SECTION2. PROPERTY OWN
//11ERSHIPt
2.1 Owner'of Record: �•
nn
Nwne(Print) City,,Slao.LIP
No.and Street Telephone I:muil Address
SECTION J: DESCRIPTION OF PROPOSED WORKS(check all that apply)
New Construction❑ E.vistilry Building❑ Os'In a III: :III ❑ Repairs(s) Alteratton(s) Mr Addition ❑
Demolition ❑ Accessory Bldg. ❑ Nurrsberof Units Other ❑ .Specify:
Brief Description of Proposed Work":
Co✓..�._c Nr-w AI;IK F/on�i• .Q�ac.e w[ �r /� c � /L
/Qe 5 I C-
SECTION 4: ESTIMATED CONSTRUCTION COSTS
hem Estimafed Costs:
(Laborand.\hnerials) Oflaclal Use Only
I. Building S 00 I. Building Permit Fee: S Indicate hose fire is determined:
2. L'lecirical S OZ y S ❑Standard City!Tussn Application Fee
I'h)nihing S ❑Total Project Cost'(item 6),4 multiplier s
aS0 O 2. Other Fees: S //�//
J, \Ic:h.mic.d illy %C) S List:.— "--' -- /L, I_6
9 \l"llanical tFne ----- L.G!
�u�+n•ssiun) S rotal .\it Pecs: S
n l'alrl Project Cost ; ('heck No. _('hcek Anwunl:
as/4 �XS ❑P.tid m Fldl C3 owsta Ming Bal.mce Duc:
Sb:("PION S: ('0NS1'Rucl—ION sF.RN'lCF.S
S.I ('unstructiun Supenisur License(01.)
-- I %+ir:uian Pale
I Icenx Nunlher I
N,une al CSI. I hider 1 Ist 01. 1')pc(sce --
_ pe Description
Na, .mJ sircet (I IhlreslricteJ IIIuilJin s li to iti,llt@ ca Il.l
Tew K ,nA_ ,a 1�_]�,. , Rc.IricleJ Ia•?I'.unil Dllellin
/1� ht;li„II
l'ini fall n.51a1e.LIP
µC' Kadin Oncri"It
N'S %Vmdow _old Sidi"
SF Solid fuel Iluminy Appliances
i Insulution
P.muil aJJreas D Drnuditian
I'ele hallo
.1,2 Registered Ilume Improvement Cuntntclar(NIC) /sag 3 !O-3�12
IIIC' Iiegletmdlun Number Ifvpinitiun Dale
I IIC C'oalpuu) Nat c a l IIC I egisnt Nai
limuil aJdtess
No. 'in We
Ci frown,State ZIP fete hung
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,C. I52.1 2$C(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?I Yes ,,,.,,,...
No....... ..,O
SECTION 7a:OWNER AUTHORIZATION TO BE C0111PLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERNIIT
Asa,. /Qi c/v c.
I, as Owner of the subject property,hereby authorize
to act on my behalf,in all matters relative to work authorized by this building permit application,
Dula
print O%mcr's Nwne(Elccuoni Signalum)
SECT ION 7b: OWNEFR OR AUTHORIZEDAGENTDECLARATION
By entering Illy name below. I hereby attest under the pains and penalties of perjury that all of the informatiun
contained in th's applies ionion is true and accurate to the best of my knowledge and understanding.
Will:
frinI(Aular's or:\uthorvcJ Alien)',N,unc I Flel;trinuc\Ign into)
VOTES:
I. .fin Owner%vhu ubwins a building permit to do his.her awn%lurk,or an owner who hires an unregistered cumncwr
(nut registered in the Hume Improvement Cuntrtutur i H IC) Program).will Litt have access to the arbitration
program or guaranty fund under M.G.L.c. 1 ?A. Other important information on the HIC Program can be found at
t Infonnaliun on the Construction Supervisor License can be found at
+, \\'hen substantial cork is planned,provide the infornill`li un below: e, finished basmtent attics decks or purcl,l
r flour area(sq. 11.1 . ----"— g g' b
Habitable ruwn euum
Grosili%ingMealsy, ll.l __-_ _ ._. . - \umherot'hedruoms
I \unlheraftircplaces ., Number of hall'halim -
\unlherafhathr.wnls . . \umhcrofJccks, pordws
klivot'lle.uings),tcm Ialdo,eJ _01wil
f%1'e pl ¢Calnlg s%ilelll
1 ..I*,,lal Prow Slltlllre 1:001.II_'e IIMS he <IIbAllilled for I otal i'rojKt C'oA"
I! - I I�.I_..... ! �I �•QIAOOI y I i ' � �i/ j � : li �I � � I
Mlcl,
I :
FM
� ,� 'Qwl I 3 So3Fitt✓o-j I p I'Sd � �i g �/ I - �._. I �.
8
LR., _... _ /..
a I I i I I I
Xrn _-�-- IL_.. L
- .
1
I
1 yr c1
Ila
�„ I �
.
pi Tt LII9SM
rk
Kb:
^�
Joy
I
I i I I I I
i I '
o
CABINETRY
.✓.�y
DESIGN
Proposal
April 20,2012
Ann Harrington
6 Sunset Road
Salem,MA 01970
(617)797-4076
We are pleased to quote you on remodeling your kitchen. All work is fully insured and all trash created
by Cabinetry By Design will be removed by Cabinetry By Design.
Cabinets&Hardware:
Supply&install Yorktown silver cabinets with platinum drawers. Cabinets are as per plan in the
Brighton door and are complete with matching Yorktowne moldings for toe space and soffit. Also
included is the hardware of your choice.
Counters& Backsplash:
Supply and install group B granite counter as per plan. Counter is complete with any standard edge,
owner to select color. Install owner supplied file and grout on backsplash.
Carpentry:
Remove existing cabinets and counters and floor to sub floor. Nail off sub floor in preparation of
hardwood. Remove the on walls up 3' and patch back with blue board and plaster in kitchen and half
bath. Remove wall between kitchen and dining room as per plan and patch back with blue board and
plaster. Block up existing door and supply and install new 3'-0 x 6'-8"nine light fiberglass door as per
plan closing up inside and out up to paint. Supply new Schlage lock and reuse owners dead bolt. Block
up existing basement window. Owner to remove existing step and install new step. Prepare mud room
and half bath floor for tile. Frame new recess for connector. Patch wood base as needed. Insulate any
open exterior walls. All work as per code.
Plumbing,Gas&Heat:
By Owner
Proposal continued on next page
56 North Putnam Street 4 Danvers,MA 01923 4 Phone 978-774-0002 1 Fax 978-774-7799
CABINETRY
3Y
DESIGN
Proposal(continued)
Electrical:
Disconnect existing kitchen and rough wire kitchen as per plan and code. Supply and install five 5"
recess lights and one 4"above sink. Relocate dining room light. Relocate all wires to remove wall.
Upon completion install owner supplied appliances. All work as per code tying into existing service.
Flooring:
Supply and install 2'/4 oak flooring in kitchen weaving into existing dining room floor. Sand dining room
and repair floor at doorway to hall. Finish complete floor with three coats of oil based polyurethane: Tile
mud room and half bath using owner supplied file and grout.
Nothing other than stated above is included. No plumbing,appliances,tile, grout,painting or masonry
step in quote.
Cost: $22,985
Total Contract: $ ja, '79
Terms: 30%down, 20%upon starting,40%upon delivery of cabinets, 10%upon completion c
, y � r
Qb-M C4 -s� I I S mc>II —
Owner "' Date
'chard F.Brown,President Date
HIC License 915283
Options:
1: Change counters to soap stone add$1052 to quote
Selections
Wood: Maple Door: Brighton Color: White Hardware Door:
Hardware Drawer:. Counter: Edge:
Harrington-April 2012
56 North Putnam Street 4 Danvers,MA 01923 4 Phone 978-774-0002 4 Fax 978-774-7799
' 1
CITY OF S.UZNfs AUSACHUSETI"S
JCtLDLVC DEP.1AT1tF.VT
I 20 Tt RNCTON STXW, 1'O FtO04
•�. ft+1. �97Z� 74l�9S9!
K11153tALSY ORLSCOLL F•Vt197� 714784d
. W04 Mom"ST.PMUS
DIAEG'T04 OP Pl:BGtC PROPl47Y�81'[LD[.YC CO1pltSstOV E4
Canstructlon Debris D13pos31 Affidavit
(required for all demolition and renovation work)
In accordance with the sixth edition otthe State Building Code, 780 CMR section I 11.J
Debris, and the provisions of MGL o 40, S J4;
Building Permit o is issued with the condition that the debris resulting from
Ihis work shall be disposed of in a properly licemed waste disposal racility as defined by,bIGL c
111, S I30A.
The debris will be transported by:
(name of eular)
The debris will be disposed grin :
((,Ame o1'�fy) ' �—
G
I, ras or r,. I ,r)
�rt�NrO v(„ermil ,pphc,nf
11 a..;u'Itucrrh- bellartment of Public Safel
Bo-trd of BuildinE Rc_ulatiun. ;Intl ';lawkln .
i-
License: CS 81143
JAMES R PHILLIPS
16 BRpOK ST °wP
TEWKSBURY, MA 01876
Ezprralian: 6/16=13
. r'"nuai..i.ne... Tr: 79360
,tom Elie
Office of Consume��"���pij'air�s giuess egulahond License or registration valid for individul use only
HOME IMPROVEMENT ACTOR before the expiration date If found return to
-. Registration .1 CONTR52838 Type: Office of Consumer Affairs and Business Regulation --+a
Expiration ]t)/3`/2012 Private Corporation 10 Park Plaza-Suite 5170 _
CA ETRY BY DEFGNAN =�-'� _ Boston,MA 02116
RICHARD si owl
d
R 56 NORTH PUTNAMCSS
r ,.)
r DANVERS;'IIAA 01923
Undersecretary.
Not valid without signature
CITY OF S,U.F_M, NWSACHUSE"ITS
� 1 BUILDING DEPARTmE..NT
120 \li/.\SHLNGTON STREET Ya FLOOK
TEt_ (979) 145.9595
F.L�c(979) 7 f0.9836
I.\IBtALEY DRISCOLL
AkYO Z I�tO�L\3 ST.PIaaRB
DIRECTCa CF PULIC PROPERTY/01:I2DING CO\LAWIONER
Workers' Cumpensalion Insurance AlTldavit: (3nilders/Cuntractorv/Electrlcf3ns/Plumbers
\nlalleant Inrormatinn // Please Print Le,zihly
Name lUmitu,�Urgamrafinro Individual): e��lr�lil e:Jr t ti 4 ) 4
Address: SC /V /OV CT
Cily/StatelZip: DO- 'Lr Q /1,- n /g29 Phone to! 4 P— ??Y—coo-x—
Are yt an employer'!Check the appropriate boat Type of project(required):
I. I mn a umployer with _ �_ j. ❑ I arrl a gcnaml contractor and I
colployces(Rau and/or pan-time).• have hired the sub-contnetars 8. ❑Now,cunstruction
2.❑ I am a soft proprietor or partnut- listed on the mlached rhtcL t �• ❑Remodeling
..hip and have no employees These sub-conlmetors have I C]Demolition
working for me in any capacity. workars'camp. insurance, y, O Building addition
(,No workers'.comp. insurance S. C] we are a corporation and its
required.i officers have daarcised their, 10•0 Electrical repairs or additions
).❑ 1 mn a homeowner doing all work right of efedrnptiun per MGL 1 I.C]Plumbing repuirs or udditions
myself. (No warkers'Gump, c. 152, 11(4),and we have no 12.0 Roof rupairs
insurance required.) t employees. (No workers'
cump, insurance required.i U.Q Olhar
.\uy.,ppll,:un JW d"Nies but at mail if"rill out,hv c.criuq bufaw.hawing Odle"ken,mmpen"dun pulley innumurton.
I hvnuuwnws w110.uluoll fhlt ailleavil indieaing they.n doing all,wrk and then hit#uafeide<amrsefat#mml nthmll s new alydavil indiotine,w),
r,�mrxwre thel ch,vk this bud mud.uach d Oi.Ldaalunul.hme,huwing the nwne of the rupeunfruWn and their workers'mmp,pulley In/umunoq.
/urn an eulp/uyer that/1 pruvldlnX IvorROn'eompauadun Grsaranry�or my emp/uyg0se 8e/aw Is dte pallet'and juh We
in/arrnadne,
Insurmcu Company Naine:
Policy J or Selr-ins. Liu,d: EApirution Date'
job Sift Address: Cityisfute/Zip:
.\hest"a copy of Iht workers' componsatioe Palley declarmlon pigs(showing the pulley number and tspinlloo data).
F'.liluru to wcuru coverage as required under.Section 2JA ur:ttGL e. 152 can?dad to the impodiiian afcritninal penalties of s
tine up Io i I,SO0,d0 und/ur one-year impri.mnmco4 as well as civil penalties in the tbrm of a STOP WORK ORDER and a line
If ill)to S_a 50_00 a dry iguinst rite violator. lie advised that a copy ur this 141cment may bu furwardcd to ilia 011ieu of
to rcdig.tinn.�of the 0IA tur insunoce covaegc vcrific_tliun.
!du Irrrrby rnri!y under 1110 pairu O's JJ p—rn�ah1e.r,/parjury that tire iqurnlurlon pruyiJaJ ubuvr ie uu0 rnJ Carter,I)uru:
U/jicin/u,c nrly, /).n,rl writ•in t/sir arras, ru.Se rumylet✓JV rfry ur town njfh'ial
City-if Iwv't: _. _. i'crmir/l.fcen,e i
(„uiird.\utharily feircld one); _.—.-. . .._
I. !fuard ul llnith !. Iluildlm" Ucp.trnnenl 1, 1'it).faun Cferk I. Iffcetrlc.tl ht.pccbtr i. I'lumldn•{ Infpector
4. tither
07/13/2012 09:54 FAX 978 532 2217 CROSS INSURANCE 2001
A� CERTIFICATE OF LIABILITY INSURANCE /13/2012
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 15 WAIVED, subject to
the terns 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 endomement(B).
PRODUCER N E:A Lauren Goldmaa
Cross Insurance-Peabody Px°"E (978)532-5445 Fate ISTe)s1z-zz1T
139 Lynnfield Street E•MaLtlgoldman@ cressagency.com
INSURERS AFFORDING COVERAGE NAIL R
Peabody MA 01960 INSURERA:Nat:ional Grange Ins CO
INSURED INSUREFB:NatiorLal Grange Mutual Ins Co 47B6
Cabinetry by Design Inc. nisunseavTechnology Insurance Con an
56 North Putnam Street: INSURER::
"URFA E
Danvers MA 01923
INSURER F:
COVERAGES CERTIFICATE NUMBFR:CL121959316 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.
Be TYPE OF INSURANCE POLICY EFF Y� LIMITS
POUCYN MBER
GENERAL LIABILITY
EACHOCWRRENCE S 1,000,000
COMMERCIAL GENERAL LIABILITY PRNAiIET RqM LI S 50,000
A CLAIM"ADE ❑OCCUR aB34944 /1/2012 /1/2013 MR)E%P(Any as mean S 5,000
PERSONAL 6 ADV INJURY S 1,000,000
GENERAL AGGREGATE $ 2,DO0,000
OENLAGGREGATE UMITAPPLIE$PER: PRODUCTS-CDMPIOPgOG g 2,000,000
X POLICY PRO- LOC §
AUTOMOBILE UABILr1Y COMBIN INOLE LIMIT
O nl
]3 ANY AUTO BODILY INJURYfd
3 250 000
ALL ONPoED X SCHEDULED B34944 /29/2012 /29/2013 BODILYINJURY(Per SAUTOSAUTOS500 000
X HIRED AUTOS X AUTTTQ6' PROPERTY` AMAGS 100,000
UMBRELLA LIAR PIPAaeic $ 8 000
OCCUR EAGH OCCURRENCE $
EXCESS LAB CLAIMS•MADE AGGREGATE §
OED RETENTIONS S
C MRNFRS COMPENSATION WC STATU- OTH-
ANDEMPLOYERTUABIUTY YIN
OFFICERIMEMBER EXCLUDEAW D ECUTIIE❑ NIA E.L EACHACCIOENT S 200,00
IM]MwprI,InFR) rinc3254809 0/11/2011 O/11/2012
RYee,Mseundw EL DISEASE-EA EMPLOY S lOQ 000
DESCRIPTION OF OPERATIONS hmow EL DISEASE.POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES(Amuh"ORDIM,AadNlenal RvMTk559hedU1e.11 map 9""IB mgwd )
Refer to policy for exclusionary endorsements and spacial provisions.
CERTIFICATE HOLDER CANCELLATION
(978)740-9846
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Sa1exL ACCORDANCE WITH THE POLICY PROVISIONS.
Tom McGrath
120 Washington St. AUTHORIZED REPRESENTArnrE
Salem, MA 01970 �p {J y
Timothy Tramonts/1IDS Gv»9�si +�ar.. faTl�i
ACORD 25(2010/05) 01988-2010 ACORD CORPORATION. All rights reserved..
INS025 po1o05I.01 The ACORD name and logo are registered marks of ACORD