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9 ORNE SQ - BUILDING INSPECTION ' �� The Commonwealth ofMassachusetts .,, ,;, ��"��v�`� �,�,� Board of Building Regulations and Standaz3��F�� `�"Vyg,,��'EM � ��.�j'�,:< Massachusetts State Building Code, 780 CMR �� '�I` Revised Mar 2011 Building Permit Application To Construct, Repair,Renovat�0i�F��aai�aA � S� ' One-or 'I�vo-Family Dwelling This Section For Official Use Only Building Permit Number: Date pl�ed: � Buildin Official � �� //" � g (PrintName) Signature � Date � SECTION 1: SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map &Parcel Numbers � r � rf ��/sy1�/ �j:ZTd.•OyS1 3•'�aS , 1 11a Is this an accep d street?yes ✓ no_ . Map umber Pazcel Number � 13 Zoning Information: 1.4 Property Dimensions: \� Zoning Dishict Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Frort Yazd . 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 ifyes� � SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: . Tn� S'/'��ncLa.�a �c.mor� ��/o_rri. /!lA O/97� Name(Print) � O City,State,ZIP 9 Dr/JB.SGi�n�G 9��y�i>�.� ,me�na/�iGmor�,ou�a�eo. No.arid Street Telephone Em Address �y SECTION 3: DESCRIPTION OF PROPOSED WORKZ(check all that apply) - New Conshvction❑ Existing Building ❑ Owner-Ocwpied ❑ Repairs(s) C1 Alteration(s) ❑ Addition ❑ Demo]ition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work2: �l2 e._ � �'�_. 2��am�'y' �Qp-^`'�{lrcn,, f ;-,6,��`i�"<.-�C `�`� �.�e'l�1 l�.�C1..t.. ,. SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Labor and Materials Official Use Only 1.Building $ g�� 1. Building Permit Fee:$ Indicate how fee is determined: ❑ Standazd City/Town Applicarion Fee 2.Electrical $ S'o-0 � ❑ Total Project Cost'(Item 6)x multiplier x 3.Plumbing $ g d . C1� 2. Other Fees: $ /� �/�G� 4.Mechanical (HVAC) $ List:_ �� "� � 5.Mechanical (Fire $ Su ression Tota}All Fees:$ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ d� 6a ❑ Paid in Full ❑ Outstanding Balance Due: C`Gt,� Gt�� .�,c�-,,�� SECTIONS: CONSTRUCTIONSERVICES , 51 Construction Supervisor License(CSL) ��1�� ti �� c+�" ��j�,�'�(l� LicenseNumber Expirati Daze Name of CSL Holder J , � �--� List CSL Type(see below) ��rT. �� No.and Street �-� Type . Description � �J q�( � � � �n �� Unrestricted(Buildin s u to 35,000 cu.ftJ � R Restricted I&2 Fami] Dwellin Ciry/Town,State,ZIP �" � M Maso RC Roo£n Coverin WS WindowandSidin � fse''"Y��L�'• ��,o.�� SF Solid Fuel Buming Appliances �� " �� _��s,.�r.fl.i..�ry.pl I Insulation Tele hone Email address D Demolition 52 Registered Home Improvement Contractor(HIC) $��i� � � "*a��k�L'Z-� HIC Regishation Number Expiration Date HIC Com�any Name or E-IIC Registrant Name � � �—��SZ��'CJs Ai�-C. No.and S eet �/ ' Email address �6v�--. �-Q 3� ^�uY� � 2 �� 1 O �C�� Ci /Town,State,ZIP '�� Tele hone 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 bailding permit. Signed Affidavit Attached? Yes ..........+3�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,heteby authorizey�y'� ////'�'JL/V to act on my behalf,in all matters relative to work authorized by this building permit application. �P o,o��.'��inore �• �'•�70/L Print Owner's eme(Elechronic S' ature) Date SECTION 7b: OWNER� 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. ��e�a,o� .�aS�G�io�� - 8'd0/� Print Owner's or�Authorized Agenp,�6 Name(E(ectronic SignaNre) 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 azbitration program or guazanty fund under M.G.L.c. 142A.O[her important infortnation on the HIC Program can be found at www.mass. ov/oca Information on the Construction Supervisor License can be found at www.mass.eov/d�s 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including gazage,finished basemenUattics,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 CosP' �roposttl PageNo. of Pages Semper Fi Builders � Jeff Turner 57 Riverview Ave.,Danvers, Ma 01923 ' '" SemperFiBuilders@comcast.net 978-590-4019 PROPOSALSUBMITTEDT`O�,,� (� PHONE -7 DATE ��T 'k Vv`rJ p� ��e '17.27 � � L � �� u.�.�.Q �� STREET JOBNAME y �rn.e � l.a.c.�.rC � CITV,STATE and ZIP CODE JOB LOCATION S wl.� `�t\c O��c o S' v�.� ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates tor. � .�.... \..t0..q..�+��.... \-!?��...........Q`�i....... �'�.C+�t�1 A tR \....�.... N.1.S�'��.... . ` .. .._ � ... ... . � _..._ ...... ...... `S �V�4s-� W... �r_.,��.- .�. ..,,..... �L9.n�S��w.o� ��2.. �A��'. O r�... � .r Jl- G .--.c,� � -+-�. .........b c.�, o-v� Se�w � .................. __ _ _ �¢ �C0�J08¢ hereby to furnish material and labor— complete in accordance with above specifications, for the sum of: dollars($ �e, sm� ) Payment to be made as follows: All material is guarantead to be as specitied. All work b be completed in a workmanlike manner according to stantlartl prectices.Any aHeration or deviation irom above specifications Aulhorized � involving e�ra cosis will be erecuted only upon wrinen ortlers, antl will bacome an e�re Signatufe charge over and above Ihe estimate. All agreements contingent upon sirikes, accidents or tlelays beyond our coniroi. Ownar to carry fire, tomado and o�her necessary insurance. No�e:This proposal m ? Our workere are fully coveretl by Workman's Compensation Insurance. withdrewn by us if no�accep�ed within t 0 d8y5. ��P�l�nCe Ol �r��Q$tt� —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature � to do the work as specified. Payment will be made as outlined above. Date of Acceptance: Signature � "�'..:,.... �`.P . �YII�JII�ttI PageNo. of Pages Sesnper Fi Bu"siders Jeff Turner 57 Riverview Ave.;Danvers, Ma 0192� ° Serssper�Buildera@comcast.n�L �, 478•590-4019 PROPOSALSUBMITTEDTO PHONE DATE �'\`'�c * �ro , e 91 �l �3 �„n-.c. 1 l. STREET� '� JOB NAME '� ��•t J .<-c C3. QLV�STATE and ZIP CODE JOB LOCATION �"`• �3 '�� t�t�l0 � SJ�.M- A\RCHITECT DATE OF PLHNS JOB PHONE i�O �We hereby submit specifications antl estimates idr: 1. � �� Co .d.,�\.R e <-o�c�� y �sc�.�' .�«Q � i� Cl:''�Co-�.9..,,� �'y � � 1 �. ,t�f.,�.r4Q w Co: .F�-.-: _ ' �'�s1�h,.� 'jz �,u�^ O^ � .ra� G -;..e��'��f..�� 0�.�. � trv�. Se�w c4 �`t�o-R_ n S n 4 1 _ yt . , ��.:�J `� ,. , � [� 1,f LU'� � YhC' t t� e� t!+.'^ f. y'l t'�. ti. \i_ti�e.'t �1 �s .s� k ., l.y �{ � -.,;,t,+1.��.�_P i�'C, C i.t,�'"C. ..�" 'C=� ca,``z � ; �� ,. t �f �tOpOSP hereby to furnish material and labor— complete in accordance with above specifications, for the sum of: i�..�}C � 1� �i �{�` �'m� dollars($ b�, ). Payment to be made as follows: All material is guaranteed to be as specified. All work ro be completetl in a workmanlike manner according to standard practices.Any alteration or deviation trom above specifications Authorized involving exira cosis will be executetl only upon writlen orders, and will become an extra Signatufe charge over antl above the estimate. All agreemenis contingent upon strikes, accidents or delays beyontl our conirof. Owner ro carry fire,rornatlo antl other necessary insurance. Note:This proposal m �bg Our workers are fuliy covered by Workman's Compensation Insurence. withdrawn by us if not accepted Wiffiin �/� dayS. �tCP�lttnCe Ol �r��Q�tt� —The above prices, specifications � and conditions are satisfactory and are tiereby accepted. You are authorized Signature to do the work as specified. Payment will.be made as outlined above. , Date otAccep[ance: ' Signature �,,.� rt ��a��tt� PageNo. of Pages �ee�per Fi Buoldsrs � � Jeff Turner 57 Riveruiew Rve.,Danvers, Ma c1423 Seraper FSuildar�@cemcast.net T�•.. 9T8-590-4019 PROPOSAL SUBMITTED TO PHOfd[ DATE " `N`c � �M r� �, �. ,O�e �i�,@ Z`t l ��1 Sl3 �3 w--Q t l. STREET n JOBNAME g �f..� J � �•-c F� QTV,$TATE antl ZIP COOE ' JOB�LOCATION �..' S�,¢s,.. '��c. ��t O � C.�.JI.-�..- ARCHITECT �ATE OF PLANS JOB PHONE �� We hereby submit specitications and estimates foc �, 4j � t I 1, �,o �\.� � �m�� u,�, �r.st�s .�«Q � ,� c�.;ro-��r.� �� 'C .l�,�nQ VJ COs .F'4-. .�. .. �.L9.nJ$�ce'u,�C, ��2 `P� � � � .t J� G --.�c� `�.,..�1. �oc.�,. , o-r— Se�w � ��o-s't_ � , £ �; �� t -r- r _a . t � a , r '� �?� �,�� '��` �., ,#"` �• s � a.�._ .^ _.�� Lr 7'c-�* t" L C � � E-i" . 1 C. "` L. . �, x, � �P �CO}108¢ hereby to furnish material and labor— complete in accordance with above specifications, for the sum of: �..tfa � .• dollars($ �1 � , S�� ). Payment to be made as tollows: Ail material is guaranteed to be as specified. All work ro be completetl in a workmanlike manner according ro stantlartl prectices.Any alteralion or deviation from above specitications Authofized �� involving extra cosis will be esecutetl only upon writlen orders, and will become an e#re SignatUre charge over and above ihe estimate. All agreemenis contingent upon sirikes, accitlents or tlelays beyond our con�ml. Owner to carry fire, tornado antl other necessary insurance. NOtO:ThiS propOSal m = \Our workers are tully covered by Workman's Compensation Insurance. wi�hdfaWn by US if no[aCCepted within � 0 dayS. �CtP�IttriCP OL �rO�OStt� —The above prices, specificatiuns and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified. Payment wilP be made as outlined above. , Date of Acceptance: Signature C7TY OF SALEM, MASSAQ3iJ5ETl5 B��r�xr � 110Wi�VSA�B'!',3mFlAONt 7�L(h78)7�5-9595. ' Feac(978)7�f498�6 BIA�RiEYDRISQ7I,L MA]'OR ?Y�ssST.P�RF DmEca�sz ar+r�ucrx�r/s�a� Construction Deb�is Disposa/A�davit (required for�all demolition and,.renovation worrc)� 1n aacordanoe w(th the sixth edihon of the Siate Building C�e, 780 CMR, Sectinn 111.5 Debris; � and tfie provlsions of MGL c90,S 54; BuUding Permh�t is Tss�red with tl�e conditfon that the debris resulting from this woric shall be disposed of tn a propedy Iroensed � waste deposit facility as defined by MGL c ili, S 150Y4. � The debris wi0 be transported 6y: � �� -�.�-�,1� . . (narne of hauler) ' The debris will be disposed of in: . M.�� S � � (name of fadlity) l 33 (c�,e o � c. ��Y1 (address of facility �—_� Signature of plicant �� 5� c ti � ' Date � � The Commonwealth ofMassachusetts � Deparhnent oflndustrialAccidents , 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia ��'orkers'Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers. TO BE FILED WITA TAE PERMITTING AUTHORI'CY. Applicaot Intormation Please Print Leeiblv Name (susiness/Orga.uzanon�naiviaua�): �C�� '��,t¢S'ILOJL.. Address: �� r� '�� ✓l City/State/Zip: ��µ2�ZJ `�'\c� Phone#: �' "l� ��*� �� `f Are you an employer?Check tAe appropriah box: 1�Pe of p�Oject(rel�Uired�: , 1.�I am a ployer with employees(full and/or part-time).' 7. ❑NeW COnst[UChon 2. am a sole proprie[or or parmership and have no empioyees worlpng for me in $. �Remodeliilg any capaciry.[No workers'comp.ins�uance required.] - � � 9. ❑Demolition 3.❑I am a homeowner doing all work myselL(No workers'comp.insurance required.]t 10�Building addition. 4.❑I arn a homeowner and will be hiring wntracrors to wnduct all work on my property. I will ensure that all contractors either have workers'wmpensation insurance or are sole 11.Q Electrical repairs or additions proprierors wah.,o employces. 12,Q plumbing repairs or addirions 5.�I am a general contractor and I have hired the subcontrac[ors listed on the attached sheet. 13.Q Roof 7ePai75 These sub-contractors have cmployees and have workers'wmp.insurencx.= 6.❑We are a corporation and its officas have exemised their right of exemption per MGL c. 14.�O[t1EL 152,§1(4),and we have no employees.[No workers'comp.insurance required.] - . .. .. . . _ . . . . . . . . . . . .. ... . . . . . . .. . _ .. _. . .. . . _. . •Any applicant that checks box pl must also fill out the section below showing the'v workers'wmpensation policy mformation. r Homeowners who submit�his affidavit indicating they are doing all work and t6eu hire outside contractors must submit a new affidavit indicaeng such. . =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and siate whether or not Nose rntities have employees. If the sub-wntrac[ors have employees,they must provide tAeir workers'�wmp.policy number. . I am an employer that is providing workers'compensation insurance for iny employees.� Be[ow is the policy and job site ' injormation. ^ ` �� A , �� Insurance Company Name: l.,� 19 �� — Policy#or Self-ins.Lic.#: �� 3 � � � 3 2�8�^O �Expiration Date: 1 L I 2`3 I 1 � Job Site Address: �� `J`r`� `"e�`�'C� City/State/Zip: �W�`-��S `l"�t. (�CQ�3 Attach a copy of the workers'compensation policy declaration page(sLowing t6e poticy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-yeaz 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.A copy of;his statement may be forwazded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cenijy under the paias and penaUies ojperjury that the information provided above is true and correcL Si ature: CS`-��' Date: 7---'� �9--��C. � � Phone#• Q�� 0 1 � i O�cia!use only. Do not write in this area,to be cnmp[eted by ci[y or town o�ciaL . City or Town: PermiULicense# Issuing Authority(circle oae): 1.Board of Health 2.Buitding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other � Cootac[Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, - express or implied,oral or written." An employer is defined as"an individual,par[nership,association,corpora6on or other lega]enrity,or any two or more �. of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartrnents and who resides therein, or the ocwpant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto sha]]not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also s[a[es that"every s[ate or local licensing agency shall withhold the issuance or - - renewal ot a license or permit to operate a business or to construct buildings in the commonwealth for any . applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its poliNca]subdivisions shall enter into any contract for the performance of public work unti]acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the conlracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checldng the boxes that apply to your situation and,if . necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Parhierships(LLP)with no employees other than the members or partriers,aze not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Depaztrnent of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the atfidavit. The affidavit should be retumed to the city or town that the application for the permit or license is being requested,not the Departrnent of Industria]Acciden[s. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please cal]the Department at the number]isted below. Self-insured'companies should enter their self-insurance]icense number on the appropriate line. City or Town Officials • . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom . of the affidavit for you to fill out in the event the Office of Investigafions has to contact you regazding the applicant. Please be sure to fill in the peimiUlicense number which will be used as a reference number. In addirion,an applicant that must submit multiple pemvt4icense applications in any given yeaz,need only submit one affidavit indicating cutrent policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially s[amped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or ticenses. A new affidavit must be filled out each � yeaz.Where a home owner or citizen is obtaining a license or pernvt not related to any business or co7rnnercial venture (i.e.a dqg license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The DepartrnenYs address,telephone and fa�c number: � The Commonwealth of Massachusetts Department of Indushial Accidents i Congress Street, Suite 100 Boston,MA 02114-2017. Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 02-23-15 www.mass.gov/dia CO T � ,� � �,. �4�M/N6� Salem Historical Commission 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 �s�s�sis-ssas FAX(978)740-0404 CERTIFICATE OF APPROPRIATENESS It is hereby certified that the Salem Historical Commission has determined that the proposed: ❑ Construction ❑ Moving ❑ Reconstruction � Alteration ❑ Demolition ❑ Painting ❑ Signage ❑ Other work as described below will be appropriate to the preservation of said Historic District, as per the requirements set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: McIntire Address of Property: 9 Ome S�uare Name of Record Owner: Ian and Penelope Bigmore Description of Work Proposed: Install one vent pipe near rear chimney. Pipe to be 2" in diameter and 18" high and painted dark gray/black to match slate roof Dated: May 11, 2016 SALEM HISTORICAL COMMISSION sy: �-t-f,.� � —�� -�- I �— The homeowner has the option not to commence the work (unless it relates to resolving an outstanding violation). All work commenced must be completed within one year from this date unless otherwise indicated. THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of Buildings (or any other necessary permits or approvals) prior to commencing work. ,acoRo� CERTIFICATE OF LIABILITY INSURANCE �TE,MM,°a'r`�„ �,/ . 6/22/16 TI-0S CERTIFICA7E IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON iHE CERTIFlCATE HOLDER THIS CER'f1FICA7E DOES NOT AFFIRMAi1VELY OR NEGATIVELY AMEND, EXTEND OR AL7ER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUfHORIZED REPRESENTAl1VE OR PRODUCER,AND iHE CERfIFlCATE HOLDER. IMPORTANT: If the certifcate holder is an ADDITIONAL INSURED, ihe policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the tertns and conditions ofthe policy,certain policies may require an endorsement. A sta4emeM on this certifinte dces not confer rights to the certificate holder in lieu of such erWorsemenqs). PROIX10EFl NTA NAME: William J. Lynch Insurance Age PHONE g�8 750-0044 Fn/X No: �978) 750-eeoe 92 High St. aoortEss: WilliamL nch@L chInsurance.com 2nd Floor INSUf� S AFFOROING COVERAGE NAICM Danvers, MA 01923 irisunertn:Commerce Insurance INSURED INSURERB:LIY)ELt Mutual Insurance Jeffrey Turner INSURERC: Semper Fi Builders INSURERD: BOX BB INSURERE: Danvers, MA 01923-0168 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PFfiIOD INDICATFD. NOTWITHSTANDING ANY RE�UIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TI-� POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANDCONDITIONS OFSUqi POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AODLSUBR POLICV EFF POLICV E%P LTR TYYEOFINSURNJCE POII(.VNUMBER MNDIY MM/DdVYYV LIN➢TS ],, GENERALLIABILITY gDj�(�`j�[�T 10/7/15 10/7/16 EqCHOCCURRENCE 8 S OOO OOO X CONT1ERCIALGENER4LLIABILITV DAAMGETORENTED $ SOO OOO ClAIM5h1ADE OOCCUR MEDEXP(AMa�P�sm). $ S OOO PERSON4L&ADVINJURV $ S OOO OOO GENERALAGGREGATE $ '1 OOO OOO GEN'LAGGREGATELIMITAPPLIESPER PROOUCTS-COMP/OPAGG $ ]. OOO OOO POLICY PRO- lOC � $ IW TOMOBILE LIABIU7V COMB INED SINGLE L IMIT Eaaccitlertl $ ANVAUTO BODILYINJURY(Perperson) $ PLLOWPED SCHEOULED gO01LYINJURV(Perxciden�) $ AUTOS NON�OWNED Pe�acatlenDMMGE g HIREDAUTOS _ AUTOS $ �� OCCUR �.CHOCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ OE� RETENTION$ $ B WVRKERSCOMPENSATION wC2 - 31S-370004-01: 11/zs/is 11/23/16 }( WCSTATLL OTH- /W D EMPLOYERS'LIABILITY OFFICEWMEMBEREXCIIAED?�CUTIVE v� N�A ' ELEACHACGOEM $ ZOO�OOO (Mandabry in NH) EL DISEASE-EA EMPLOYEE $ SOO�OOO Ifyes,tlssvibe untler i DESCRIPTIONOFOPERATIONSbelow E.LDISEASE-POLICVLIMIT $ SOO OOO ' t � OESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (AlHch ACOR�101,AEtlitionel Rerterks Schedule,if more sFece is raqu retl) ..-. C?�struction Operations in MA } CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE � THE EXPIRATION DAIE THEREOF, NOTICE WILL BE OEIJVERED IN I3II B1CJmOL'B ACCORDANCE WITH 1HE POLICV PROVISIONS. 9 Orne Square Salem, MA 01970 aun+oaizeo SENTATIVE OO 7988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/OS) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: . NOTE — NEW WALL NEEDS TO BE � BUILT 4"-6" INTO EXIST. CABINET AND KITCHEN PANiRY TO MAKE . �z'—��' ROOM FOR TOILET ROOM 1'-10�" t p .%m EXIST BEDROOM � PANTRY ,o�-� b� B lH a ''Lp�- 0 i � SECOND FLOOR SHOWER/ BATH 3/e'�i'—o' KITCHEN . . PANTRY 3�-0�"+/— 0 �—��• fD TANK N OVERHEAD ' (SIM TO 'WHITLOW . DESIGN') NEW < CLQSET � FIRST FLOOR HALF BATH EXIST � I NEW I � ,� I +i2•�+•-�- CHIM E BATH � v�J SH R EXIST EXIST � SHOWER , HALL CLOSET � 5�'t • PR ME�MLINE i ! ` _•-�� 31�"X31�• BATH PLANS SCALE: AS NOTED f� ,�,.�� BIGMORE RESIDENCE 5-/ — � �� 9 ORNE SQUARE SALEM, MASSACHUSEI°fS OVERHEAD (sM m •vminow RICHARD �V. GRIFFIN, ARCHITECT� s o� I � 7 Z _ c�, Z 5�� D�«�') C Jun 27 2016 08:15AM Bigmore Office 978-741-1753 , , page 1 FAX MEMO TO: Salem Building Inspector FROM: Orne Square Condo Association DATE: June 27, 2016 FAX: 978-740-9846 RE: Building Permit for 9 Ome Squaze To Whom It May Concern: The Trustees of the Ome SGuaze Condominium Association are aware of the proposed renovations for Unit#9 and approve these projects. The work is to be done by Jeff Tumer of Semper Fi Builders of Danvers. Orn ��i e Square Association Trustee I