10 SUTTON AVE - BUILDING INSPECTION T>
LF3 . `°�
The Commonwealth of Massachusetts
OF
�,5 Board of Building Regulations and Standards CITY M
Massachusetts State Building Code, 780 CMR SdMar
Revised Mar 2011
Building Permit Application To Construct,Repair,Renovate Or Demolish a
One-or Two-Family Dwelling
Building Permit Number: This Section For Official Use Only
i Date Applied:
Building Official(Print Name) Signature Date
SECTION 1:SITE INFORMATION
1.1 Property Address•'�j1 1.2 Assessors Map&Parcel Numbers
�[7 SU'/TU/1 �U E
L l a 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(sit 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? Municipal ❑ On site disposal system ❑
Check if yes[]
SECTION 2: PROPERTY OWNERSHIP[ -
2. Ownep, of Reco d: _
/I/1> 2�P_� GSGj2n/1 /AA 01970
Name(Print) City,State,ZIP
/!G .5 H, Awe j7S?- '? 7:2 77
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK (check all that apply)
New Construction ❑TExisting Building❑ I Owner-Occupied ❑ 1 Repairs(s) Alteration(s) 'V I Addition ❑
Demolition ❑ 1 Accessory Bldg.❑ 1 Number of Units I Other ❑ Specify: _
Brief Description of ProposedWorkz: a
/ wiv-fie,
SECTION 4:ESTIMATED CONSTR CTION OSTS
Item Estimated Costs: Official Use Only
Labor and Materials
I.Building $ — 1. Building Permit Fee: $ Indicate how fee.is determined:
2. Electrical $ C ��G ❑ Standard City/Town Application Fee
❑Total Project Cost (Item 6)x multiplier x
3. Plumbing $ D0 2. Other Fees: $
4.Mechanical (HVAC) $ List:
5. Mechanical (Fire $ Total All Fees: $
Su ression
Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ aC-/ (�0 ❑Paid in Full ❑ Outstanding Balance Due:
xA v �18�
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL) D6T- 115 U
6f0,d—/,ej License Number Expiration Date
Name of CSL Holder
,� / / List CSL Type(see below) D 3 2d Z
l2 /V ew ce,—S fa c e
No..and,Street /y Type Description
tom/ex/ MOy/t"h/ /// /1 t)2�Op G U Unrestricted(Buildings u to 35,000 cu.ft.
!r r l/ R Restricted 1&2 Family Dwelling
Cityfrowrf,State,ZIP M Masonry
RC Roofing Covering
WS Window and Siding
r p /' / SF Solid Fuel Burning Appliances
/ - S-U/ " J 7 /0 I 1 Insulation
Telephone Email address D Demolition
5.2 Regist red Hie Improvernent Contractor(HIC) b7 s��
Nar�ri�1t radG>,t 0 r ( e-G HIC Registrationn Number Expuauon Date
I IC Com any Name or HIC IR istra t Name
No.and Stre Emad address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152.§ 25C(6))
Workers Compensation Insurance affidavit must be c pleted and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuan 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
to act on my behalf,in all matters relative to work authorized by this building permit application.
Print Owner's Name(Electronic Signature) Date
SECTION 7b:OWNER' OR AUTHORIZED AGENT DECLARATION
By entering my name below, 1 hereby attest under the pains and penalties of perjury that all of the information
contained in this application is true and accurate to the best of my knowledge and understanding.
l��+�i A kit tci CZ/6- Z� D 20/Z
Print Owner's or Authorized Agent's Name(Electronic Signature) Data.
NOTES:
I. 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.eovioca Information on the Construction Supervisor License can be found at www.rnass.eov/
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 halfibaths
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"
�i.a>Y K tr«.efts .. Grpaa eiaCiN f YeNfiu ixl�ry
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u.x,a..a+.tsmy SLper:.:;c, ..censy
-L¢ Cnse. P64is .
BRADF(M fl tft fFl
12 NEW T
WF-YMCIUTA-t
ism
fie
O @i"ce C- onacumer ai anc ne eon
1 D Park Plaza - Suite 5 170
Boston, Massachusetts 02116
Home imp»rovetContractor Registration
Regfstranon: 136539
Ype'. SumletTletrt Card
NORFOLK FACTORY DIRECT KITCFi€, $,. _xplralon 812r2012
, '
BRADFORD KURCIVIEZ __-_.----
265 WOOD RD
BRAINTREE, MA 02184
1=pdate Address and return card. Mark reason for¢$sage.
Cal G 5a4oaw.c:0+2,6 . , Address __ Renewal Fmpbvineat - Last Card
tM�e at Caasneacr AtAirs&Animas-Re¢ofatina License or registration valid for individul use:"Iv
-
MPROVEMENT CONTRACTOR before the expiration date. If found return to:
reaon:,y 3g (Ngee of Coasamer Affairs and Business Regaiation
ftw yam' 10 Park
-Plana-Sane 5170
E '2 suppiemert can�i Bostno,MA 021 ab
Ai(F _-KITCHEN&BATF- :.':
285VVCODRO
BRAINfREE.&tA 021PrF
- EndereerrHan' Not valid without u2nature - -
,- CITY OE S.u.E.N[, Alss.lCH(,'SETTS
KLLONG OEP.1RT3tE`T
I 'O p.IiNGVGTON STXW, 1'OFLCCIt
� I1r1. �978) 14S.9S9!
1C13®ERr Ry OUSCOLL P.Vt(973) 1 40-9&id
MAYO It rkamu ST.AEAAS
O rIt8CT04 or Pt SLIC PROPffATY/eC MDCjQ CO\13/IS3)ON EIt
Con9tructioa Debris D[gpOS31 Affidavit
(required for sU demolition and renovation work)
In accordance with the sixth edition orihe State Building Code, 730 OUR section 111.1
Debris, and the provisions of,MOL a 40, 3 54;
Building Permit a is issued with the condition that the debris resulting from
Nit work shell be disposed of in a pro
I 11. S I JOA. perly licensed waste disposal facility as defined by ,XICL c
rho debris willbe transported by:
'(n.una of hauler)
The debris will be disposed of in
(name or hciluy►
lddrefl arl�rili�y)
V —
fn�Nro of permit rpphtrnf
— se.AzI�a/_�__
'pia
CERTIFICATE OF LIABILITY INSURANCE DATE i 611/12
Producer THIS CERTIFICATE IS ISSUED AS A MATTER OF
INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
Association Benefits Insurance Agency CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT
600 Longwater Dr AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY
Norwell,MA 02061
THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
Insured INSURER A: MA Retail Merchants WC Group Inc.
Norfolk Factory Direct Ktchn&Bath Otlt N INSURER B:
265 Wood Road
Braintree,MA02184 INSURER C:
INSURER D:
INSURER E:
COVERAGES
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 DESCRIBEDHEREI N IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY
ADD EFFECTIVE DATE POLICY EXPIRATION
INSR LTR INSRn TYPE OF INSURANCE POLICY NUMBER MM/DD/YY DATE MM/DD LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Anyme fire) $
CLAIMS MADE O OCCUR MED EXP(Anyone person) $
PERSONAL&ADV INJURY $
GENERAL AGGREGATE $
GEN'LAGGREGATELI MIT APPLI ES PER: PRODUCTS—COMP/OP AGG $
PRO-
POLICV JECT LOG
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (ER..,dtl nt)
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Perpersnn)
HI RED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per eccdent)
PROPERTY DAMAGE $
(Pe'..dent)
GARAGE LIABILITY AUTO ONLY—EA ACCIDENT $
ANY ALTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR ❑ CLAIMSMADE AGGREGATE $
$
DEDUCTIBLE $
RETEWION S $
WORKERS COMPENSATION AND X VJCsTATU- OTH.
EMPLOYERS LIABILITY TORV LIMITS ER
ANY PROPRIETER/PARTNEWEXECUTIVE E.L.EACH ADO DENT $ 100,000
A OFFICER/MEMBER D(CLUDED?
IT yes,descnbe under NO 014000500736112 1/01112 1/01/13 E.L.DISEASE—EA EMPLOYEE $ 100,000
SPECIAL PROVISIONS below
E.L.DISEASE—POLICY LIMIT $ 500,000
OTHER
DESCRIPTION OF OPERATIONS(LOCATIONSI VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Kitchen remodel
CERTIFICATE HOLDER ADDITIONAL INSURED:INSURER LETTER'. CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Annette Cote&John Ponte THE EXPIRAT10NDATE THEREOF,THE ISSUING INSURERIMLL ENDEAVOR TO
10 Sutton Avenue MAIL 35 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED
Salem,MA 01970 TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
c
NORFOLK KITCHEN & BATH PROPOSAL..................
265 Wood Rd.
BRAINTREE, MA 02184
PHONE: 781-848-5333
FAX: 781-848-2722
H.I.C.# 136539
ANNETTE COTE &JOHN PONTE r PAGE - 1 OF 3
10 BUTTON AVE MATERIAL #204371
LABOR # 204372
SALEM, MA 01970 DATE: 5/5/12
DESIGNER: DIANE PHONE: 978-745-7277 J
NOTE: NO REFUND ON SPECIAL ORDER CABINETS AND COUNTERTOPS Int. - �.:._.
We hereby submit specifications and estimates for
i
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NORFOLK KITCHEN & BATH WILL SUPPLY AND INSTALL SHOWPLACE CABINETRY IN A
PAINT GRADE MAPLE SPECIES ON A CONCORD DOOR STYLE WITH A SOFTCREAM
FINISH, INTERNATIONAL OVERLAY, SLAB HEADERS AND STANDARD GLIDES.
NORFOLK WILL ALSO SUPPLY( 29)HANDLES #1584-FB.
NORFOLK KITCHEN & BATH WILL SUPPLY, TEMPLATE, AND INSTALL A COUNTER TOP,
GRANITE IN MATERIAL, HONED VIA LACTEA , 4" BACKSPLASH, AS123D 10/10 SINK,
THE COST OF THE COUNTER TOP WILL GO UP, THIS PRICE REFLECTS A DIFFERENT
QUOTE—CUSTOMER IS AWARE.
*FAUCET IS NOT INCLUDED AND MUST BE ON SITE DAY OF INSTALLATION OF COUNTER
TOP.
• NORFOLK WILL SUPPLY A DUMPSTER ON SITE
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DEMO LABOR TO INCLUDE:
• TEAR OUT KITCHEN CABINETS AND COUNTERTOPS — FLOORING IS TO REMAIN —
• EXTERIOR WALL TO STUDS.
• REMOVE AND SAVE SOFFIT MATERIAL ABOVE
****SCROLL MOLDING ABOVE CABS WILL BE SAVED AND REUSED. SAVE TONGUE
AND GROOVE PANELING ON SINK WALL AS WELL.
CARPENTRY LABOR TO INCLUDE:
• INSTALL ALL CABINETS, MOULDINGS, AND HARDWARE PLUMB & LEVEL ACCORDING
! TO THE 20/20 DIAGRAM.
• SUPPLY AND INSTALL INSULATION AND FIRE BLOCKING ON EXTERIOR WALLS.
• SHEETROCK EXTERIOR WALL, TAPE SEAMS (WALLS ARE BEING COVERED WITH
EXISTING TONGUE AND GROOVE IN BACKSPLASH AREA.
• SUPPLY AND INSTALL WINDOW TRIM AND SILL, INSTALL TONGUE AND GROOVE
BOARDING TO SPLASH AREA (CLOSE MATCH).
• REINSTALL SAVED SCALLOP TRIM AND CROWN ABOVE CABINETS .
• PATCH BASE MOLDING AS NEEDED.
• REFINISH EXISTING WOOD FLOOR IN KITCHEN AND HALL (3 COATS OF POLY).
PLUMBING LABOR TO INCLUDE:
I
• REMOVE EXISTING SINK, DISHWASHER, AND DISPOSAL.
• CUT AND CAP WATERLINES
• INSTALL NEW SINGLE-BOWL SINK, FAUCET, DISHWASHER, DISPOSAL, AND LINE FOR j
ICEMAKER
• SUPPLY BASKET STRINAER
• RELOCATE GAS LINE AND INSTALL NEW GAS RANGE.
• VENT SINK TO CODE. ***PLUMBER MAY BE ABLE TO TIE INTO EXISTING BATH VENT
HOWEVER, IF NONE EXIST ADDITIONAL LABOR WILL BE QUOTED TO BRING A NEW
VENT STACK UP THROUGH THE ROOF.
PULL PERMITS/SCHEDULE INSPECTIONS
***`CUSTOMER MAY WANT TO MOVE SOME PIPES IN EXISTING CHASES RELOCATED.
THIS WILL BE QUOTED BY PLUMBER AFTER DEMO AND WILL BE ADDITIONAL CHARGE.
ELECTRICAL LABOR TO INCLUDE:
• SUPPLY AND INSTALL 4 RECESSED LIGHTS.
• NEW 20AMP CIRCUIT FOR MICROWAVE.
• ELECTRICAL FOR GAS RANGE /NEW LOCATION.
• ADD/UPDATE COUNTERTOP GFI OUTLETS TO CODE.
WIRE DISPOSAL
• WIRE DISHWASHER
• TERMINATE/RELOCATE WIRING AS NEEDED (FAN , EXISTING OUTLETS ETC...).
• RELOCATED REFRIGERATOR OUTLETS.
INSTALL 2 CUSTOMER SUPPLIED PENDENT LIGHTS ABOVE SINK.
• PULL PERMITS/SHCEDULE INSPECTIONS
CUSTOMER IS RESPONSIBLE FOR :
• FAUCET
• 2 PENDENT LILGHTS
ALL APPLIANCES
I ,
*THE COST FOR PERMITS VARY TOWN TO TOWN AND HAVE NOT BEEN DETERMINED OR
INCLUDED IN THIS PRICE, ONCE THE COST IS DETERMINED, IT WILL BE ADDED TO THE
SALES ORDER AND WILL BE THE RESPONSBILITY OF THE CUSTOMER TO PAY.
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ALL SOLID SURFACE COUNTERTOPS ARE PRICED AS ESTIMATE ONLY. TEMPLATE WILL
DETERMINE FINAL PRICE.
WE PROPOSE hereby to furnish material and labor—complete in accordance with these
specifications for the sum:TWENTY FOUR THOUSAND THREE HUNDRED AND SIXTY $24,541.63
THREE DOLLARS AND 23-4100.
n o i
Material payable as follows: rk l
Designer/Salesperson
15i Payment due upon ordering(50%) + $ 436257
20"Payment due before delivery(50%) 4362.57
Ili TOTAL: $ 8725.14
it Labor payable as follows:
1"Payment due upon ordering 130%) 4744,94
2n0 Payment due upon start of job(30%) + 4744.94
3' Payment due day after template(30%) 4744.94
0 Payment due upon completion(10%) 1581.67
TOTAL: $ 15,816.49
ICI All material is guaranteed to be as specified.All work to be completed in a workmanlike manner
I according to standard practices.Any alterations or deviation from above specifications involving
I extra cost will be executed only upon written orders and will become an extra 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.
ALL INSTALLATIONS ARE GUARANTEED FOR 1 YEAR .
ACCEPTANCE OF PROPOSAL—The prices,specifications,and conditions are satisfactory and
are hereby accepted.You are authorized to do the work as specified. Payment will made as
outlined above.
! customers�� // f' j ( t
Signature Y,.L fT1.l.nT{. �'u .l ,�-'E-! ' Date 2... _—__ _ —
155;"
24" 2' 151• 74:" 24" 15" '•
41;.. 73;.. 25;1 .7...8;
ZB.. 30.. 47
PIPE CHASE
38" 24" 36" 24 18" - 15"
OR
UF� 15 b424WCD RB 24.DISHW 2Bf 8R Bt3�F3 A N
M
m
O N
m a WALLCABINET
K NOTCH OUT BACK
c31 N PER DRAWING
m m u n m
BASE CABINET u.
N FALSE DRAWER FRONT
- b NOTCH OUT BACK OF CABINET
N PER DRAWING
C <
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vl (n > m
A
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RADIATOR
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ANNETTE COTE JOHN PONTE -
m
DATE SOLD'.515/12 >
MANUFACT SHOWPLACE
WOOD SPECIES.PAINT GRADE MAPLE
STAIN:SOFT CREAM PAINT
GLAZE:NIA
DOOR STYLE:CONCORD t� 24..
CHASE
.... ..
OVERLAY:FULL
DRAWER HEADERTAIL
DRAWERS DOVETAIL//STNDARD GLIDES -' 1Z. 191'
DOOR HARDWARE:158
DRAWER HARDWARE 15ISM - in
COUNTERTOP'.HONED VIAA LA LACTEA GRANITE
4"BACKSPLASH.PENCIL EDGE
qp.
CUSTOMER HAS REVIEWED ALL CABINET
SPECIFICATIONS.SIZES AND MEASUREMENTS
AND IS IN AGREEMENT WITH THEM, o BUILT IN SOFA AREA
CUSTOMER ALSO UNDERSTANDS CUSTOM ORDERS n
CABINETS AND COL NTERTOPS ARE NOT RETURNABLE.
Customers Signature _
Designer's Signalere�IL,= I
87'
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