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31 NURSERY ST - BUILDING INSPECTION
The Commonwealth of Massachusetts UhlBoard of Building Regulations and Standards SITTY OF Massachusetts State Building Code,780 CMR� Revised Mar 2017 i Building Permit Application To Construct,Repair, Renovate Or Demolish a One-or Two-Family Dwelling Thus Section For Official Usvonly BuildmgPermitNumber. DateAppl/d: Building Official(Print Name) Sig tore - Date' SECTION 1:.SITE INFORMATION 1.1 Property Auurrss: 1.2 Assessors Map &r Parcel Numbers f 1.1 a Is this an aceepte 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 Dis osal System: Public Id' Private❑ Zone: _ Outside Flood Zone? Munici al Qn site disposal Check if yes❑ P posal system ❑ SECTION 2: PROPERTY OWNERSHIP' 2.1 Ownerr of Record: n ,XQdC-+ Srtn� elr (" N Ct 1& .Srr(e wt Vhk a 1 g70 Name(Print) City,State,ZIP 3/ n/ur�S'er�sf 97B 59 No.and Street Telephone Email Address SECTION 3:.DESCRIPTION OF PROPOSED WORIO (check all that apply) New Construction❑ Existing Building❑ Owner-Occupied Repairs(s) ❑ 1 Alteration(s) Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units I Other ❑ Specify: Brief Description of Proposed Work: ra.n elrl r/r G4r 12 acWhpv'rrn 4r, rl F/X+G rrJ r, r.rstllakr RlaC Gar+, Ala 0-V0 re YCYN.t Zc r "A,, J 't' lYl�rlr Gr..� C fn 1pr M matrC 4- A 'C Sri I/Orr.... t C.�fr' r . SECTION4: ESTIMATED CONSTRUCTION COSTS - - Item Estimated Costs. Official Use Only (Labor and Materials 1.Building $ S 0 U I Building PermifFee.$ Indicate how fee is determined: 2.Electrical $ 0 Standard City/'I own Application Fee , ❑Total Project Cost'(Item,6)x multipliers x 3.Plumbing $ 2.,Other Fcm $ 4.Mechanical (HVAC) $ List 5.Mechanical (Fire $ Suppression) Total All Fees. $ Check No Check Aiuount Cash Amount. 6-Total Project Cost: $ 17 Paid in Full - ❑ Outstanding Balance Due: vha`Q J0 c o -SECTION._5i. CONSTRUCTIONSERVICES- 5.1 Construction Supervisor License(CSL) _k-�.GY q n n�j (,� Licensee Number Expiration Date Name of CSL Hold _.;l 1 (CA 1(9V S 4- S 4 C List CSL Type(see below) l/t No.and Sheet Type I Description U I Unrestricted(Buildings up to 35,000 cu.fl. G U R Restricted 1&2 Family Dwellin City/Town,State,Elp M Masonry RC Rooting Covering WS Window and Siding SF Solid Fuel Burning Appliances 92); ��jj- 7 27 312 I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 2 s-_5;Z?/ a0/ / _. M.- y a(,tw,JkLe VrA�y "Dk HIC Registration Number xpir tion Date C.Company or HIC Registrant Narye .and Sir I Email address Ci •/Loren,S te,ZIP Telephone `SECTION6:WORKERS'-COMPENSATIONINSURANCE 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 f the building permit. Signed Affidavit Attached? Yes .......... No . .........❑ SECTION 7a:.OWNER AUTHORIZATION TO-BE COMPLETED WHEN OWNER`SAGENTOR CONTRACTOR APPLIES FOR B[SILDIINGPERMTT - I,as Owner of the subject property,hereby authorize [CAh/rIL lA NL/nn Fd to act on m beL all matters relative to work authorized by this building permit application. P t Own is Name( eetronic Signature) Date .SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below,I 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. G /✓/ 5 Print Owner'stbr Authorize gent's Name(EFectronic Signature) 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 regisferea in the Home improvement Contractor kiliu)grogram),will not have access to rite arbor auon I program or guaranty fund under M.G.L.c_ 142A. Other important information on the HIC Program can be found at mvw.maa,gm/oca Information on the Construction Supervisor License can be found at MMjRass.eov/dM 9 When m.hetantial vmr4:c dannrd nm�ridr thr inform atinn hnlmu Total floor area(sq. ft.) (including garage,finished basementlattics,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" September 6, 2012 Jack & Jennifer Ryan 31 Nursery Street Salem, MA 01970 CONTRACT Homeowner will do demo, Cabinetry Unlimited Enterprises, Inc. will plywood floor, frame walls in tub again. $19000.00 Durock all walls and ceilings in tub area, prep for tile, durock floor and prep for tile, blue board ceiling in bathroom and wall next to toilet. Skim coat plaster where needed. Blue board and plaster hall ceiling. $2,000.00 Tile Material Allowance Tile, adhesive, grout, caulking and durock Floor tile 40 sq. ft. 4' around room 85 sq. ft. (3) walls in tub area & ceiling 95 sq.ft. Caps, deco's ? ($1,400-$1,800) - $1,800.00 Labor to install all above tile($2,400- $2,800) $2,800.00 Build and install new bathroom vanity 60" wide, 36: high 21" deep in the middle and 14" deep on the sides. $1125.00 Build and install tri view medicine cabinet 36" wide 33" high 8" deep. $975.00 Build and install toilet paper topper 34" wide 36" high 7" deep with open section and towel bar across bottom. $725.00 Build and install radiator cover, built in 24" high 30" wide. $300.00 (may want to discuss capping heat and install heat under tile) (see electrician) Interior trim work, install door, towel bars, oak threshold from bathroom to hall final caulking and cleaning. $550.00 (homeowner will provide door) (may want to discuss grab bars see Peter) Permit Fees Building ($50-$100) $100.00 Total $11,575.00 Deposit $6,000.00 2"d Payment when start tiling $2,000.00 3'dPayment when bath vanity is installed $2,000.00 Final Payment $19375.00 (to be determined based on final price on tile, labor and permit fee) *Minimum 3-5 we o start job when contract is signed with a deposit r / j ; t /! Homeowner � � Cf ! Contractor ► a:; acli s€*its - De-Pal-t'l-nent of Public Sllfet8 [Ward of B"4ib;t4 Regulafi*ns zlml Standards ConstrU n Supervisor License License: CS 87554 PETER BAGAREkLA 21 CALLER ST Sl11TE 2 ° PEABODY, .A 01 6,0 Expiration: 4/28/2013 e3t117�tifi1i)7lel Tr#: t6479 08/16/2012 23:1B 7BI3222995 VELIA TRAVEL PAGE 01 ® DATE(MMIODNYYY) ACCATl CERTIFICATE OF LIABILITY INSURANCE 8/17/2012 �,, THIS :E'2TIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERT FWATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 9ELC II. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPR,MEDITATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPOi TANT: it the Certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the hS mN and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not Confer rights to the caftift 20 holder in lieu of such endorsements. PRODUCE CONT Coremercial Lines Harri E-Murtagh Insurance Agency,111C. PNoxE (978)532-2844 FA" 30 Csitral Street E-MNL INGURCRilll AFFORDI) OVE GE NAIC S Peabc ty M 01960 IMSUWRAJIrballa Protection Ins Co 41360 L21CD, INeuRERe;Hart£ord Underwriters Ins Co 0104 Ltry Unlimited Enterprises, INC ter St N 2 INSURER°Y MA 01960 INSURER F. COVER,LGES CERTIFICATE NUMBER:CL1261714083 REVISION NUMBER: THIS 1' TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICP TV). NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTII WATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLLI iIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 9111111 L�TRR TYPE OF INSURANCE POLICY NY MBE M° Y ry6FI POLICY ER LIMITS GU-;"LLU LDY EACH OCCURRENCE 3 1,000,000 X JOAMERCIAL GENEPUI LIABILITY PREi.N E 3 1D0,O00 A _I CUMSMADE a OCCUR B500053281 11/1L/2011 1/11/2012 MEO EEPAM OIM DWOOP) S 5,00 PERSONAL S ADV INJURY S 1,000 000 GENERAL AGGREGATE S 2,00 r 000 GEM,AGGREGATE LIMIT APPLES PER PRODUCTS-COMPIOP AGG 3 21000,000 POLICY PRO- LOC E. S ALIT,� alUll LIABILITY COMBINED. SINGLE LIMIT BODILY INJURY(Per person) ! LN"AUTO aUL OWNED SCHEDULED BODILY INJURY(pQeeCK Q S )U-'OS AUTOS PROP DAMP E NON-OWNED E JIREO AUTOS AUTOS S JMNRULA LIAR OCCUR EACH OCCURRENCE 4 :Xf:ESS I" CV11M` DE AGGREGATE E E MI RETENTION 3 WC STATU- OTH_ $ YJOI;EE)IS COMPENSATION AMC :MPLOYERS'UABILITJ Y I N ANY xKIpRIETORAMRTNFFIEJ(ECUTIVE E.L.EACMACCIOENT E 100 O00 MIA OFF :ERMEMBER D(CLUDED? 041721-5-12 /6/2012 6/6/2013 E.L.DISEASE-EA EMPLOYEt S 100,00 (MN;Nlnry M MM) If"; Ilv, a Miner E L DISEASE-POLICY LMIT ! 500,00 ES;RUTION OF OPERATIONS EemJ' OESCRWT a1OF OPERATION&I LOCATIONS J VENICLES(Aers.ACORD 101.AddIUMM R1AHR!SCIMEUMI It McIA WSCe Is MRUNPO) CERTIFI:_ATE HOLDER CANCELLATION (978)E.32:-6646 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED OErORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. :!JJSRISE SENIOR LIVING 3 MARGIN STREET AUTHORMEO REPRESENTATIVE 1:7.A$ODY, MA 01960 J S SOholnick/PJR ACORD t5(2010105) ©1988-2010 ACORD CORPORATION. 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