60 OCEAN AVE - BUILDING INSPECTION (2) o CKSs�a �ZS
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S g' S RECEIVE
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The Commonwealth of Massachusetts
Board of Building Regulations and Standards CITY OF
Massachusetts State BuildingCode, 780 CMR ' 1014 NOV �
- 3 �iseH�a�2011
BuildingPermit Application To Construct, Repair, Renovate Or Demolish a
PP P
One-or Two-Family Dwelling
This Section For Official Use Only
. Building Permit Number: Date Appli
Building Official(Print Name) Signature bati
1 SECTION 1:SITE INFORMATION
�f 1.1 Property Al ess: A 1.2 Assessors Map&Parcel Numbers
I l.la 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(B)
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'
2:1 caner of Recond: 0076
-. Name(Pn/n��t)' City,State,ZIP
bo (JC'(1 u 1 '1Td. `l78'y10-A13J
No.and Street .. Telephone - Email Address
SECTION 3: DESCRIPTION OF PROPOSED WORK=(check all that apply)
New Construction❑ Existing Building V1 Owner-Occupied Repairs(s) ❑ Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ 1 Number of Units Other pecify: )k.r
Brief Description of Proposed Work 2: /./ s/
Alv -vwG m ievy
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
1. Building $ Z I $'� I '' 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ ❑Standard City/Town Application Fee
❑Total Project Cost'(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4.Mechanical (HVAC) $ List: c�
5. Mechanical (Fire Suppression)
$ Total All Fees: $
_ Check No. Check Amount: Cash Amount:
6.Total Project Cost: $ 'Z� I 0 Paid in Full 0 Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
5.1 onstruction Su ervisor License(CSL)
License Number Expiratip
I R /& n Date
Name of C$JAJ�L Holder U
' List CSL Type(see below)
pn
No.and Street Type Description
n7on/w 07/7'v U Unrestricted(Buildings u el ing cu.ft.
_/L/ /1'/C(/+,nl / ' / _ R Restricted 1&2 Family Dwelling
City o ;State,ZIP - - M Masonry
_ RC Roofing Covering
WS Window and Siding
SF Solid Fuel Burning Appliances
I Insulation
Telephone Email address D Demolition
5,7/i'�,2e' /gistered me Impro ment Contractor(HIC) 6d/ O D! 16 Z „ � i I fT—
(f�y �'� 41'yb- "ItlaQ HIC Registration Number lExpiration Date
Hit'Comp T gistant Name
1S PNyrHYI N,yt,�rtd "iW rtPt, t)l7 rz- s �9a D�S-6 Email address
C,il @/Town StatelZIIP'H 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.
CI Signed Affidavit Attached? Yes .......... ❑ No........... O
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:OWNEW OR AUTHORIZED AGENT DECLARATION
By entering my name belo h e a st under the pains and penalties of perjury that all of the information
contained in this applicati is e d ecurate o the best of my knowledge and understanding.
1�1 0 I u r v�,U
Print Owners or Authorized AgW Wiknic`ftlectronic Signature) Date
NOTES:
-
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.gov/oca Information on the Construction Supervisor License can be found at www.mass.eov/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'
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass.eou.dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le ibl
Name(Business/Organization/individual): 'L M I — C —L
Address: Zip l J eiq pp/ZT- J U l T(K 9 i 10
City/State/Zip: �CzfTin& A ND13 Phone#: $p$'Z$D-DIS-b
Are you an employer?Check the appropriate box: Type of project(required):
1. W4 am employer with IS' 4. 0 1 am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction
2. ❑ I am a sole proprietor or partner- listed on the attached sheet.# 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition _
working for me in any capacity. Workers' comp.insurance. 9. ❑ Building addition
10. ❑ Electrical repairs or additions
(No worker's comp.insurance 5. ❑ We are a corporation and its 11. ❑ Plumbing repairs or additions
required.) officers have exercised their 12. ❑ of re airs
3. [1 1 am homeowner doing all work right of exemption per MGL 13. Cf ether IcJ la.('1? W
Myself.(No workers'comp. c.152,§1(4),and we have no
Insurance required.)t employees.[No worker's
Comp. insurance required.]
`Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
tHomeowners 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 attach an additional sheet showing the name of the sub-contractors and their workers'comp.policy information
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. j'�1 /�
Insurance Company Name: I'"I/}f t c11�/ / [J DYLf of TVr+L. JVl 6
Policy#or Self-ins.Lie.#::'�L DI`I QD b C ZD J O Expiration Date: I ID ZOI S' �L
Job Site Address: too t cyu( 4t. City/State/Zip: ���'M'� M 1�l
Attach a copy of the workers'compensation policy declaration 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to
$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA
for insurance rine,
rification.
I do here cer fY the pains nd penalties of perjury that the information provided above is true and correct.
Si nature: Date:
Phone# �l7$' ZBDJ DI f�
Official use only. Do not write in this area,to be completed by official.
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#:
a
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La DOUBLE HUNG WINDOW
VINYL
VINYL FRAME DOUBLE GLAZED
FOAM FILL GRIDS LOW E/ARGON
National Fenestration
NFRC CPO#: NBP-K-14.00008-0000®
_
Bating Council 00488344/001
CR100107.21 .01
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ENERGY PERFORMANCE RATINGS
0 . 27 0 . 26
ADDITIONAL PERFORMANCE RATINGS
0 .47 61
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I ffice of Consumer Affairs&Business Regulation
I
_ ME IMPROVEMENT CONTRACTOR
! : egistrabon -168616 , Type
Expiration 3PoB/2015.,' Supplement
I POWER HOME REMODELING-GROUP LLC.
' T
MARK MORDINI
f 2501 SEAPORT DRIVE"STE 6110 --
+ - CHESTER,PA 19013
� Undersecretary
j
1
Massachusetts - Department of Public Safety
Board of Building Regulations and Standards
Construction Supenisor y s
License: CS-057645
MARK E MORDII,*
18 NEWELL DR -
N ATTLEBORO MA 6U.
Expiration
09N6/2015
Commissioner
i
about:blank
i
CUSTOM REMODELING AND IMPROVEMENT AGREEMENT
auysrUT kdormatian and Deacdplbo of#0 Property: Project Number:31.28688 October 2t,tau
Rich Mobile aava .+wc
RRa Mobile
peded6(Rill's Cab db.nobYa�yOnam.Can
Bs,Own Me EYWNNm,
Salem.MA.01970
County:Essex 1
Township:
Buyer(s)listed above hereby joklty and severally,agrees to purchase the goods and/or services of Power Home Remodeling Group
and its vendors CConbacto!')In accordance with the prices and terms described in this 6 page document and the Product
Specifications,which are Incorporated as part of the Agreement(coteetvely,this'Agreement'). This Agreement represents a Cash
sale of goods and services. Buyers)agrees to pay the cost of the goods and services purchased as described herein,regardless of
timing or approval of any financing Buyer(s)may seek for their purchase"
Purchase Price: $2,611.33 Pro Installation Inspection Dates:
Down Payment $0.00 Thu torso hd.een CIBPN ZASP
Balance Due on f2,611.33 Estimated Project Start:6 to 7 weeks
Substantial Completion: Estimated Project Completion:1 to 2 days
Method of Payment Check ew.,in ut„anisapargealraa sun uma axnpleam nth..mraoraraw�.ao.bears
fnweGcraoatrd mrl�a,eee fnal¢b@q sn.r�.x.s�ererar,+uoea eandesmu
Buyer(s)hereby acknowledges receipt of a copy of the pamphlet'The Lead-Safe Certified Guide to Renovate Right,informing -
Buyer(s)of the potential risk of lead hacaard exposure from renovation activity to be performed in or at Buyer(s)'Pmperty,at the
written above.Buyers)receNed this pampNet on the date of this Agreement,before commencement of work
r gs Buyer(sy Initials.
This Agreement constiMes the entire agreement and understanding between the parties,and INS Agreement replaces any and all
prior negotiations,representations,or agreements,ether written a mi. No amendment,modification or waiver of this Agreement
shall be vakd or effective unless in writing and signed by both parties. Buyer(s)hereby acknowledges that Buyers)1)has read the
entire Agreement all has received a completed,signed.all dated copy of this Agreement including the two accompanying Notice
of Cancellation forms,on the date first written above and 2)was orally bylormed of his/her right to cancel this transaction.
Buyer(s)also agrees and understands that If Buyer(s)finances the work with a third-party,the terms of Nat financing will be
Contained on separate documents,including any finance charge. -
Future promotions nth applicable"
DO NOT SIGN THIS AGREEMENT IF THERE ARE ANY BLANK SPACES.
I have read and received each page of this a page agreemam.
r H he modeling Group Bu r( ) Buyer($)
/1 O/27fl4 A' t.-l -N r7� 11021174 r � .h!$'� /10121/14
Signature of Remodeling Conaultant Signature Signature
David Mock Rich Mobile Rite Mobile
YOU,THE BUYERIS),MAY CANCEL THIS TRANSACTION AT ANYTIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY
AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF
THIS RIGHT.
October 21,2D14 21:07 - INLY{ �IY It I�j �I Page t of 6
1 of 1 12/1/2014 6:25 AM
r'
NATIONAL HEADOUARTERS Rich and Rita Nobile
2501 Seaport Drive, Chester, PA 19013, " P�WER 31-28688
n J October 21,2014
888-REMODEL
.. . .. .....
MA HICi!168616
PRODUCT SPECIFICATIONS
Buyer(s)'Information and Description of the Property: Project Number: 31-28688 October 21,2014
Rich Nobile D.teofAgr enl
Rita Nobile - (978p4303436(Rich's Cell) @g
rita.nobile onons.com
60 Ocean Ave E-M.#Address 1
Salem,MA,01970
County:Essex
Township:
Buyer(s)listed above hereby jointly and severally agrees to purchase the goods and/or services listed on the accompanying specification
.. sheets, in accordance with the prices and terms described in the Custom Remodeling and Improvement and the Product Specifications
(collectively,this"Agreement").
.Pre Installation Inspection Date:Your pre installation inspection is tentatively scheduled for Thu 10/30 between 1:45p and 2:45p.
Windows -SL 2700 Inclusions: Includes metal reinforced meeting rails and nighttime safety locks on double hung windows
only,welded corners, foam injected frames, Sashlite technology, Heatshield, Duraglass, exterior custom capping, installation,
clean up and haul away of all job related debris.
It is agreed and understood by and between the parties that the Product Specifications,along with the Custom Remodeling and
.. .. .. Improvement Agreement,constitutes the entire understanding between the parties, and replace any and all prior negotiations,
representations, or agreements,.either written or oral. The Product Specifications may not be changed, modified,or varied in any way unless
such changes are in_writing.and signed by both Buyer(s)and Contractor. Buyer(s)hereby acknowledge that Buyer(s)has read the Product
Specifications.
I have read and received each page of this 2 page agreement.
Power Home Remodeling Group Buyer(s) Buyer(s)
/10/21/14 /10/21/14 /10/21/14
Signature of Remodeling Consultant Signature Signature
David Mock Rich Nobile Rita Nobile
YOU,THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY
AFTER THE DATE OF THIS TRANSACTION:SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF
THIS RIGHT.
�iiEu October 21; 2014 21:07 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIII
Page 1 of 2
NATIONAL HEADOUARTERS Rich and Rita Nobile
2501 Seaport Drive, Chester,PA 19013. u.a4.,-„y -. 5 POWER 31-28688
October 21,2014
888-REMODEL
.. ...
MA HIC#166616
Project Specifications
Windows, bedroom2 1 31.0"x60.0"
WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None B
OPTIONS: Color White/White: Grid Pattern: None I Removal Aluminum/Vinyl I Additional Details
None
7
1
Windows: i master 1 28.0"x44.0"
WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None
OPTIONS: Color While/White: Grid Pattern: None I Removal Wood I Additional Details None
i
t �
i
Windows: i master 1 28.0"x44.0"
.. WINDOWS: Models SL 2700 Styles Double Hung Types None Configs None l9
OPTIONS: Color White/White: Grid Pattern: None I Removal Wood I Additional Details None
Q
October 211; 2014 21:07 IIIIIIIII IIIII)IIIIIIIIIIII)II IIIII IIII IIIIIIII
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