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35 OSGOOD ST - BUILDING INSPECTION I,lie Commonwealth of Massachusetts - - - CI"I'ti' OF SALEKI Board of Building Regulations and Standards Massachusetts State Building Code, 780 CMR Reri.ceJ.11ur_olI Building Permit Application To Construct, Repair. Renovate Or Demolish a One-or Two-Fumilp Dn ellinq This Section For Official Use OI Building Permit Number: Date Appli, _ — fi Building Official(Print Name) Signa Date SECTION 1: SITE INFORMATION 1.1 Propert Address, 1.2 Assessors Map& Parcel Numbers 3. s s� I. ,I a Is this n accepted street?yes_ no Map Number Parcel Number 1.3 Zoniug Information: 1.4 Property Dimensions: Zoning District 1 roposed Use Lot Area(sq II) Frontage(II) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply:(M.G.I_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 Ow_Zrlo�Record: /t / O�'Cf70 L c2GY'CZ c-Lc.V'2N ZP w0 JCi� Name(Print) City.State, ZIP 3 11— ©r 9� 's►t No.and Str&t Telephone Hmail Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units_ I Other ❑ Specify: Brief Description of Proposed Work': SECTION 4: ESTIMATED CONSTRUCTION COSTS Estimated Costs: Official Use Only Item (Labor and Materials) I. Building S _ 7910 1. Building Permit Fee: $ Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical S ❑Total Project Cost'(Item 6)x multiplier x i, Plumbing S 2. Other Fees: S 4. Mechanical (IIVAC) S Lisv 5, \lechanical (Fire S Total :\II Fees: $ — a� SUllresslon) Check No. Check Amount: ___C:uh :\mount:----- 6. Total Project Cost: S 3 ©�.. �w, ❑ Paid in Full ❑ Outstanding Balance Due: Aut,-I +,0 f1cow e69 SECTION 5: CONSTRUCTION SERVIC'F.S 5.1 Construction Supervisor License(CSL) Li S S 3.9r - Name o(C'SI. I folder r/,y(z License Number ICspiratinn D;ue -- /Z, 4_ List CSL I')PC(see he low)tLKf_es,/' e No. ;ad Street Type Description u t Lnrestri-Led 13uildin�s up to 35,000 cu. II.) C'iq/fawn,State,ZIP / R Restrict la@? Pumil Dtccllin> M klason RC Roolin,C'ovcrin W'S Window and Sidin ev%'✓-. t%r`VC P79-S'3,6�d>j� Co-� SF Sold Insulation Burning Appliances GL • ti-P� I Insulation Telephone limail address D Demolition 5.2 Registered Home� Inprovement Contractor(HIC) y 7 ���'Y I III ian nmc or I IIC egistranl Name C Registration Number I?.cpir lion Uutc f y rwNa Z No.and Sir J {fit.ri;QoGLPih�t� AAA 0/?t/4/ e75-1-V-40Sc, E n mail address' C /Town, State,VP 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. 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. Seed Print Owner's Name(Electronic 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. Print Owners or Authorized Agent's Name(171ecuonic Signature) Date =77in 1. An Owner who obtains a building permit to do hisor an owner who hires an unregistered contractor(not registered in the Home Improvement Contractm),will rhot have access to the arbitrationprogram or guaranty fund under NLG.L. c. I12A. information on the HIC Program can be found atni:y..go oca Information on the Constructioicense can be found at w ttr<.mels:. �o�_,Ills --------- - 2. When substantial work is planted, provide the information below: Total floor area(sq. It-) _(including garage, finished basement'attics,decks or porch) Gross living area(sq. It.) _ Habitable room count Number of fireplaces-----_—___ Number of bedrooms _---- ---------- Number of bathrooms -----------__---_ Number of halfbaths ------- --- 1) - ------------..—_ Number uf decks, porches Enclosed .. 3. "Folal Project Square Footage"may be substituted tin"rota) Project Cost" '� CITY OF SALEM V't1' [PUBLIC PROPRERTY 3d DEPARTMENT \Irn w ' 11: \ttAMllAI:I V.\jlaFkl' • j,111•N, M.1 U.U.I II 4 I nJl'll] Ihl. nf1?Iivi+! • I'r.r v7M•?tC•'isM Workers' Cumpen3311on Insurunce %If ldvit: lfuildcrs/CuntractorWElectrlciang/Plumbers \ 1 111cant In unnatio PI • .v I/nt Legibly V;I IT7C 1111m,Ic%yl)(Awl N,1iQnN Ind,V lJuul l:-D� c Za � �jy�L \ddrus.v: Z y //LG�. �u�/el LL Ciry,Sr:uc.%ip• ram' �'!/l �ih/nr�/: 9'? 'g'j33 Y1��-tom I .try yuu ad vinplill Cheuk IIII JPpreprlule boa: I.❑ Lint a umpluyvrwith 4, [] 1 am a general cnnlrxloir and I l)PQ firpro)vet(required): 2•Qvnipluycea(lull and/ur parwjtlle).a huvo hireJ lhv.vuh•cunlraclun fl• ❑Now cutlsltucllun 1 .1111 a sole prnPrictltr or partner• limed on rht anachcd.sheet. �• ❑Remotkling ship and have no cmpluycus TI sr subcontncron haw working tilt me in Any capacity, vor:116 Comp. Insurance. g' �••r Demoliriun 3)<r( nn ,E I NO wur#en'culnP. insurance J. We are a enl 9. El Building aJdiliute /4 14 VW ruyuircJ.) pontion anJ its ntrlacn have Qvemived their 10.0 Electrical repairs or additions 1.❑ 1 mn a hl/InVltwller duind all work right of C.remption per IMrL I L❑Plumbing rcpuire or aJJitiory myself.ln'o markers'cuntp• C. 1 J2,J I(s),anJ we have no insurance required.) t :mpluyeve. LNO workers' 12'❑ *1'repairs mrlIL insurancercquireJ.) E •'\iI>.ygMca„1 tll,e cl'vcb e,la AI meal:Jw NII uW I ho'I lulwrlwnew wl w'.afmif Ills anldarir indlVlina Ih"4Y.Cull IRIYr dwrl,ry Ilr,lir n'Weya'416 juind cumir,yWkm PWky Il, eliUm r,nlnlane.Ihel.Acca,hu Ira Inlw anacntd In add,liulW.11,rl Juriila irly nany hi N as him sidd der rmll"Inwt.atrrl,rmril a lyr alndevil indic,e,n ,. anus and Ilse%weirs' a w OF urn un vnrp/eyer their IF providoq workers,Cumpenrnr/oe Luaranve foray rp d rn lu lert 'I1Ohcy Inlbrmanue iulururulkla '�j !!jj Bdurr/i tArpugry on✓/u1 aih In.uraucv C'umpwry .Vnmr. Y � er+-a' / p / Y Policy a ue SulGina. Lie.Mt�Q—'� S� L . .. . Eapiruhon Dare: p /0 lab Site, Addrevr ��cw �N � 1RJ.A Ir cu C'ny,JluterLlp: c�e arc /lA�fl ©��'� yy of Ilul rrorkore'u Palluro uuaeruge as require rnpvmatlua pulley Juclarullen page(ahowlnq the Polley numbur and expiration ddu_te). lu wcuro red wider Sccliun IJA ul'.NGL c. 32 cad lead to the imposition o/criminal yenelriee o/a tin. I'll to 31.5410.0)0 andiur une•year impri.r,Imncot, a. hull.la civil pcnalha in the,turn ul'a STOP \YUR nlup re i230 r10 i Jay Iduinal Ih• violanv. fie advi.tud that a uupy urthl% liwinunt may be ORDER ;nJ i fine 1'1% �aulnu ul';liu MA ;or mlo a rarc,: ,acrayo rvnt)canun. 1'urwarJuJ to the UI Of du hereby I vrti/).mr✓,+r poirtr on✓ ,r � Will rh r der iu/ur,nrr/o1w1p.'rurh/e✓ re Or tprue nn✓rorrvrt:Is-•IIb16 / � —Cale. (/tii Gi �` iul u,r oily. Ao,mr Irrire in this arvu, ra be rao,pAvr✓ey airy air lows a/1/eiul � l7ry ur I'nwn: _ I Ir.uing .t ulharily (circle n�eh Parmif/l.ltanta I j IL,.Ord ,lllvahh i. IAp.lrtory IhuLbm. ul I. Cill.'r�rnn C'Ivrk 4. UvLtria•,il lily )ccrur 5. 6. IAhYr. I ('fl/mpiny Inryccror i I .� I'hll lla• y,• information and Instructions co,n CmA on for heir cnlpluyees. eve lion to the service of.inuher under.uty cunimct of Nire. �g,ls;achu.etta licnerol in fTv lu�reris J fn1aJ as.�ll eugryo�rs to Provide wurken I`nr.u.Llr to 1111a �taWle, p \Pecos or unphed, oral or written... to .vnplupar n defined as"an individual, purtncmhip.asaoeiano°, corporation a i other legal eastd ro any two or tnon oycr. or �t the tarcgulny engagcd to lomt enterp rise, and ❑eluding he legal rel&I%mo y,em loy"'e`n sloifses I Howevcrh he ecetver or trustee of.m indivtJJal. pstmenhtp, association or ocher legal¢nary,employ"'a the c r+hen w do maintenunca,construction or 14171119 e��emed to be inccolpl ycr." owner r s dwelling{house having not more has thee. aparaMents and who resides therein,or the occupant of Oris Iw.lh IS lwuid of another who employ. fx or on the.rounds or building appurtenant thereto shall got because of such employment CSC 6 also sfua that 'sear) stale or local Ileensfall alleaey shed withhold the Issuance or \IGL ch pier 152. �_ O ulr.d.' for anY ateumpdance with the Insurance coverall*req renewal of r license or prrmlt to operate a huslnsss or to construct buildings Is tog'iu politic 1 subdivisions shall :tpplleunt rib* has not prndu�rd2SC+P)states iable r'Neither he onunonwce ealtb nor an,utcmupliarlc.with the insurance \JJilionully, slit. chapter I S_, i- t enter into any ;unteacl for he pttrtorntun ee of pit ro he convacti t c aatho�tily." requiramene of this dtapter have been p' A' Appliesuls l to our situation and.if checking the boats that aDP Y Y ad,bess(cr)and phone number(') alongLLP)tb their cacti calets)of loyevs other than the Plea ur fill out he workers' compensation alyldavit completely,p by with it employ nacessary, supply sub-contractors)n:trn.(s), hove insurance, Limited Liability Companies(LLCwor Limited eompen>a oe illsurance.(tran LLC or LLP done d. it advise)hat this allldavil tray bs subminud to the Oepuronent of Industrial nelnben or partrten, are^ot rs. 134 a to carry employees,u policy is requite hcation for the permit or license is being requested, nog the lh=po+tment of \ecidanu for confirmation of insurance eoveroaa• Also be sue*to sign and Jule the ul'lldnrlt. Tile affidavit should ho reutrtteJ to file city or town that he aDD uestions regarding the law or if you era required toaaies obtain should enter their Industrial AcciJanta, Should you have any q compensation policy, shoo l call the a any 4t.nl st the nutnbar listed below. Self-insuredcomp self-insurance license number on he a st data lino. Clry or Town Orflelab the applicanL Please he sure that the ailldavit is complete :tnJ printed legibly. The Department has provided u spat. at the Wm of he atPdavit for you to till out in the ovens the 0111ce of Investigations has to contact you regarding I'I:asu be sure to fill in the purenjuliecnse nusnbor which will be used as a reference number. to addition,an applicant ur hat moat iubmit multiple pennit'licelttueaa P,iobtSits Addressons in any "haven y.Yong iced ntd hould only wit.it"all lu utiuns i w they tit rtt policy information(if neceaaary) eJ at marked by the city or town tnay bo provided town)•",\coPy 0f the affidavit that has been Off rot fy sump' Perini, not related to any business or commercial venture applicant as proof'hat a valid affidavit is on file for tLturt pmmits or licenses. A now afllJavit must he filled nut each year. Where a home owner or citizen is obtaining a lieansa ors tie. . dugel 4 hot or permit to burn leaves etc.) said person is NOT reyuired to complete this al8dsvit- uwuons, r coopsrativa anJ f he ,>ttice ,d Investigatiuns tvuuld Itea to thank you in JJvanca fur you shoal)you have,utY 4 pleuse do nul hesitate to yrve us a call fhe U.p•unnent's addrars, telcphune aTh Coonwealth of Massachusetts oeputraent of Industrial Accident ()Me* of lavesdigadons 600 Washin8tan Street Boston, MA 02111 Tel. 9 617.727.4900 ext 406 or 1.877-MASSAFE Fax 4 617-727-7749 www,mass.8ov/dia RightFax 03-2 9/13/2011 10:32:01 AM PAGE 3/003 Fax Server +T!�T ..... . _ - ; IESUEDATE .<iTi . ' 1®LatipSCA2EII YBRD AOAAlATTPR OY E¢OQNATTONOAYISpIEOIfTFYB MO Al6El'8140MT1I6CQ11/IGLTC ^•^^� TTIf6 CS0IIVICwIEBOEB NOTAA®1L1TYFdYOH 106ATrvP1Y AS�m.6rJYDID OQ ALTIn TI�COYFiA@ NFOQWD BYTE P011�b ®fIN.TB6LLl1SFSCAT6Qi[QBQANCLSWPS BaT CONETISBSLA OONSQ1Cl•HL1R"m1T�6611BIC LLBOQFFQfL AIRBDQS/PD j RVBFBMATSYEOQ PQONO[FY.AMD SSfECPnS]PiCATE HOLSC3L OdPORTANT:ntlr cordicrtelloitYrb lm ADDITWIRAL INSURER 111A�BLyI InQtstw wd mW,*wtlIf BRODATIDN64WA d0dSlOOl8 UFmT am tm1lUu+i of#w PST.ceNaY1PdkW BW5840 BBIIwmkOl mmt.ASf d111�B IE AOB9lIm CBII/!!Ills 1D DIB rsRReatA tl0ldr M Ew�FId1 PRODUCER toNlAcr ' + PRESCOTf&SON INS AGCY INC wOtIP F" IOSEPH SCHOLNICK I 963 EASTERN AVC r= Fn MALDL•N.MA 021d6 tammt®I cwrmmloc - �RPA AFPOADINC COY6RACR IVAICP DETAILCCTISIRUC'ION AND MANAGEMF TI LLr UQURERA TRAVELERS uiDEMNPI'Y CO 12 PINE AVE INSILtER B MIDDLETON,MA 01949 1NSUBPII C INSUBFAD ' IIYSURF.iI E @SURER F COVERAGES CERTIFICATE HUNISM REVISION NUMBER' ,.lB6®TOCO!!RY TWTTIDE PODS OP mSUAANCE SAY[AD�W BAVEISPffiI�TOT�1TffiIOtID NANDABOYBFmITl�PmJCY PYSIOD DmIGTeo- p0l0.T}�TAliDD10 ANY QFQ1»+I'.TPASS OQ COYIDfifOMOP ANY CONTQ.SLTo�Q O'IiQA D<k9l�ll NRE RP3PECT2D s/OCSSSOS CTRipIfATE bAY BE umvlBOAMAYP121TAm,TIBQ1si1YA!><Y AYPOQUYL BY lIIX1MDIOPSSVSC'Pm®IPBmlls sBwYl-TTU AIJ,THCTPANS.PS�� '�'^ANn I'UMYSWNS OY I41K11 i POI2L�LIDOBBHONN NAYBAYEBPBf RPDI1LtD BYPAID(TADSs. d0f T'M.OI WHOQANf.Q ADIs, sum ftnJ NOslBEQ wmI EPY POI.1[YLIIP fJ11StlA • LTs SNSQ QwD PONVWYYYYl ' 4TMS:AI.IIAmIJTY EKNWWW+FIiE 2 nLNNffTIPFNffn S D IX:eBBiROA1.BDlSMLIJ1PNlT 14F1A655a 0 AwW.11K4 .iiVa S®BSe7L5E• (/el.:e. S n PFas-ew.e nnv S 1NII)ItT n utxow.AwsxriuTs s - OFNL AU�F.OwlE1BBlnwIJFb IFa lYnrnF�<cmxa s Dnv:r Olrlurzr Dvx wuat AvraaopmEy.••a,• a;eaeltun®.ns s W.tdx 0 ANrwBm wcnrlNmer L � ..,uM�Pwt+r�c nrnm,rdnmr s Acne..a. ❑ 9_1BI411LLNtP.6 IT.OGF3:rl1>ALMIi S u!de! 0 ILFLLAIRIA : 0 ocN.Ow'wvwvras s 0 n .>aac,,.utw nna•,m �tfso=usctz.� s 0 o:cFV IIAP 074D141AAPF AOotrFnAlL f O PEA.crOts s 0 tQTDImwF . .. L wORYPBIt'l'Bx LUBS.rm an: wn :srAmnvr A mom HDWJls LIABII.!!Y IMP 1 YM AMI IYVIYI6'1tg1A'AHTHt>a/ LEMIAa$EII! sloo o Y MA THO B9/IA'Ii 09//0112 FY.CSBCsn L Ir�w.4-1✓!_YI OBHmpmlSmlOO nn,E LItQAOB Elv.OreeTaN UFN9iD'BIN W' LL9giAb'I.IVLLT sloo.Wb - .ViIATMIGN� narmPlreB OF otcNAnarMndwnoxavvonea(.rwnAormnlol..em.w n4mtsafer.✓:a..m>-onv..m 1 ANr �amlxwTctsnv�'IuweanwaalcrNNnmAma--nm+wwY�Fcw+P Lvv�e.:L CERrIPICATEHOLDEIt- LAUREN-LAURENZANU 35 OSGOOD ST mIDILDANY OF THE ABOVE DEQGOSD MLICgB�C1YIf�L'—REPm1E TIm OMIRATIONPATETNEREOF.IIDTCZPALL@MDSLNO O SALEM.MA 01970 ACCORDpme TI¢POUCY PROY®OML Y�F9FlYR LK ., _ R3wrda.Jot.1e.- __ 1 i i A� CERTIFICATE OF LIABILITY INSURANCE 9�i2�2°oil' THIS CERTIRCATE E ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT: If tine certificate holder Is an ADDITIONAL INSURED,the pofl y(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of tie policy,certain policies may require an endorsement. A eta6/merd on this certificate does not conler dghfs to the certificate holder in lieu of such s. PRODUCER RAC Coaccercial Lines Prescott end Son Tnanrence Agency,Ino- %DIKE (781)322-2350 PAR 963 Eastern Avenue PRODUCEROIBTDKM 0038343 Malden MA 02148 aoummmAFFOROPODCOVERAGE am* Rey WSUIMRA:ArbeTTa Protection Ina Co d1360 onsu$Ma: Detail Construction ICI Management LLC onsuR C: 12 Pine Ave em;RERD: anUMERE: Middleton NA 01949 COVERAGES CERTIFICATE NUMBER.-CL112709809 REVISION NUMBER: THIS Ism CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAKED ABOVE FOR THE POLICY PERIOD INDICATED. NOTYNTHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VeeCH THIS CERTwrATE 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 SHONM MAY HAVE BEEN REDUCED BY PAID CLAMS. tm POUCT EFF �F]fP UWn6 L irPE Oi aL41mAn6E POUCYMWBfeT � wetm EACH OCCURRENCE s 1,000,00 DAMAGE r0lflgffl� S 100,000 X C/Im Ef�aLL GENF3nA1 LNB117Y sea Ea�j A CAIMSMAOE ® 500045179 1/2/2010 1/2/2011 L®� / 5,000 PBm@nAL caw MURY $ 1,000,000 SAL. QMGATE s 2,000,000 FRODLIM-EObP/OPAW S 2,000,000 GBR AGGREGATE lailT APPLES PER LC POLICY PRO- WCs dF SNGEIMeR AUTOMOBILE UA01= (EsamA s ANYAUTO 0oDLywLw(P'e'= S AIL OWED AUTOS BODaY EUURY(P'e' ddwm S SG® PROPERTY�UIEDAUTOS � E s 10ID AUT05 S NOIJOYaffD AUTOS s uresEUAIAI ocCUR B EACH OQWRRENGE i EXoam uAs CIARLSNAOE AGGREGATE s s DEnlncTelE $ REIENnOM S W:BTATU' OM eIDRImm00lVPENSATIOM ER-- No EEWIDIIERB LIABILITY YIN workere Cczgp eatlw Cart El EACH A ZMENT S ANY PRRFIETORIPAaRERIOMOUTIVE MIA 6FFsOiRCet NEMBER� ROWA DEW be laaued by Carrier EI OMWASE-EA B VAwKAMmyOESfaIPIma OFOPERAT10NSbeb E.L.DISEASE-POLICY laN7 S DEBCWPT MOF OPERIkTKMI OCAIMMIVE1D =(InMAaa ACOIm 101,Aa®oeMWmwBdeO.b.DOAIA bn>aJIW) CERTIFICATE HOLDER CANCELLATION - SHOULD ANY OF THE ABOVE DESCRIBW POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH T14E POLICY PROVISION& Laura Lauzz.zano 35 Osgood St AurAmica DnlFJ TARVE Salem, DMA 01970 i S 8cho1nick/CAB ACORD 26(2009109) ®1s86-2 0S ACORD CORPORATION. AU fights rescued. INSM / The ACORD name and logo are registered marks of ACORD CITY OF S,V-ENfj NLASS.ACHUSETTS BLMDLNG DEP.IRTMLVT 1 10 WASULYGTON STREBT, }iO Roolt TEL (978) 745-9595 KIJBF.RMY ORWOLL Rut(978) 740-9846 MAYOR NO&ILU ST.PlEXAS DIRECTOR OP maLic PROPERTY/11L'IIDLNG CONNISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 780 CMR section l t 1.5 Debris, and the provisions of MGL c 40, S 54; Building Permit At is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as defined by MGL c 111. S 150A. The debris will be transported by: (name of hauler) The debris will be/disposed of in (name of ranlity)--------------- - -- Gtt-m �7 �33 (addrea of facility) Signature of permit applicant date :.hnvR6� - Nlaswachuvett.%- Department of Public Safet} Board of Building Rc_,ulations anti Standards Construction Supervisor License license: CS 55395 RICHARD M DEVIRGILIO 12 PINE AVE MIDDLETON,MA 01949 f Expiration: 11/142012 ('..n$newi..rtrr Tr#: 7423 OHitt o nsumer`mA�rs B eas eg anoa FHOME IMPROVEMENT CONTRACTOR Regisb On: ,*147925 Type: Expiration: 823J2013 DBA - KRIENOVATIONS&REMODELING RICHARD DEVIR6160: 12 PINE AVE MIDDLETON,MA 01949-.fir Undersecretary (I Detail Construction & Management Inc. (I)CM Inc.) cp 12 Pine Avenue Insured T� Middleton, MA 01949 FIN:000633220 N LLMA Lic.#CS055395 o Tel: (978) 836-6055 Fax:(978) 777-4452 MAR #t47925 rmdevirgflia comcaAnet O LL Proposal Submitted To Work To da Be Per rned At NAME L..,e k ✓� `-� L.£K zi � z �'` 2ND CUSTOMER'S NAME Ns � s � STREET- �l � STREET N }! 3 Q CITY/STATE ^� ZIP:'�� 1lCJ CITY/STATE ' ZIP > TEL NO. ( - P - r' '�('� TENANT or JOB SITE TEL�,'# ( r) DATE: /2 2 !/ DATE ' � F O.✓( .. ) %/ We hereby propose to turnish all the materials and perform all the labor necessary for the completion of FtF ' \ ` V'✓'[:3 - Y �.t/ A� �( - � 1!! / �` E'e,f'P'K:.J f1��116f.. )! P" F� f?z tr/s y S' ��v sr yf'E°� P `6es- �7sff /`ir (' ri a ,PV Ic Ar"kFi`ce oC �_ N O ff'f� ��� �� �.�24i1!�e/.Jtr Lt" >�f.FC�e''I"E�-/GGI.€/!�!�..i". ./�./ �f C,R`i��e�C t'•r�' .S C _/0 p Q f �T `m`L Fly r) 1' � i` .j� Pc�r�` • Its c s lrr�cj3�c � P r E Fy rseAe l zit.a All material is guaranteed to to as spedfied,and the above work to be performed in accordance with the drawings am specfications submitted for above work and comP leted'n a substan'al workmanlike m err for toe sum of' , ' Total Amount DepositAmount y '-Iffa- ri6e Upon'l+ramf`r` o:j- N d'C dC A-• !T'©Fell s j0?5 2l f?CI :""'...'tS' C. �1 " Job Completion 2 Pn ( fJ� f- l�e�"' """' _•-- ^q, ($ CV, r Any alteration or deviation from abovespecifications involving extra costs,will be executed only upon written orders,and will become an extra diarge over and above the estimate. All agreements contingent unr•n strikes-acddems ordelays beyond our control. DCM,Inc is insured for liability,copies of certificate available upon request. Owner to carry all other necessary.insurance. All checks are to be made:payable to"DCM,Inc."upon job completion and your review of the project:IA minimum of 95%of the job total is to paid upon job completion. A 5%-retainer of total may be held back if there are .- any minor installation or material discrepancies which need to he address ©0'�n t Sign ahi9' o rat: ' .there are y'blank stjatS. Cd Z Respectfully submitted by: M s- ¢ ACCEPTANCE OF PROPOSAL 00 Thp above prices,spedh'Ca`tfons and conditions are satisfactory and,are h r by accepted. You are authorized to do the work as specified. Payment II be(ma�dte- as oWmed+abo nderstand this contract may be void ot a pted.within thirty idays of a proposal date: Date:7+ vffi )f .- Accepted: .. oil V , (T Customer's Signature while Copy-Customer Yellow Copy-Merchant • '-Pink Copy-Merchant a< < B1,L �,�es �r� �n a ���� Laura Lauranzano 82711 Aj( �e�Q �i�2S PrpPOSecp ciPu� c€�Kslh fU 0. f4a�ir�d..�y.�,�.l�.ilY• Vlfh_�It_•_�, f ?JL _ fllwd xcw CD I ._ EAST CiOL.111V+S 5T. ti a�• E o •• li o Lyyp oT�'i�TATb oplT44AAI-66 H B6FN6Y N " uA'tr�M. A3S in 1 '0AG•A �If••.e IOrT . ffi n 1'6tlti� tots. .•1 O 1 f�lA,4 rml QN11 N^ 1 Detail Construction & Management, LLC. 12 Pine Ave. Middleton, MA 01949 Phone: 978-836-6055 rmdevir ig lio@comcast.net Fax: 978-777-4452 MA. CSL#CS055395 MA. Reg.#147925 pcTwc. �Ets� - - oases l�f�u e7N kxy ��➢� dr l®�i r �eGLD �P # fir( �r�rswre Vo jc� s y c q(vats a v© �c�t I i �a