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1 PARALLEL ST - BPA-13-414 INSULATION The Commonwealth of Massachusetts uk Board of Building Regulations and Standards CITY OF Massachusetts State Building Code, 780 CMR SALEM Revised Mar 2011 Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: ate Applied: Building Official(Print Name) Signature Date SECTION 1:SITE INFORMATiff 1.1 Property Address: - 1.2 Assessors Map& Parcel Numbers 1 Parallel Street 1.1a 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(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[ 2.1 Owner'of Record: Stephen P Lovely Salem MA 01970 Name(Print) City,State,ZIP 1 Parallel Street 978-745-8274 No.and Street Telephone Email Address SECTION 3:DESCRIPT ON OF PROPOSED WORK'(check all that apply) New Construction❑ Existing Building Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work': Install air barrier, moisture management and insulation system(s) to redefine the thermal envelope, and control below grade moisture within the crawlspace basement SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building $ 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: D 5.Mechanical (Fire $ Suppression) Total All Fees: $ Check No. Check Amount: Cash Amount: 6.Total Project Cost: $ 7,200 ❑Paid in Full ❑Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) CS 43436 7/12/13 James F Basnett Jr. License Number Expiration Date Name of CSL Holder U List CSL Type(see below) 14 Gilson Road No.and Street Type Description Littleton MA 01460 U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted I&2 Family Dwelling City/Town,State,ZIP M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances 978-952-2552 jim@basnettdbr.com I I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) 132490 2/15/13 J.F. Basnett Co., Inc. HIC Registration Number Expiration Date HIC Company Name or HIC Registrant Name 14 Gilson Road jim@basnettdbr.com No.and Street Email address Littleton, MA 01460 978-952-2552 Cit /Town, State,ZIP 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 Issua Va 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 to act on my behalf, in all matters relative to work authorized by this buildinpermit appplication. 1, as Owner of the subject property,hereby authorize James F 6asnett Jr. to act on my behalf, in all matters relative ork n=rized this building permit application. Stephen P. Lovely it (l4 11 I1-X, Print Owner's Name(Electronic Signature) — 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 undersT14JIA James F Basnett Jr. Print Owner's or Authorized Agen' �e(Electronic Signature) Date 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.eov/oca Information on the Construction Supervisor License can be found at www.mass.gov/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" 3" Closed Cell Spray Foam Insulation (SPF) (air barrier &R-20 thermal barrier) D. p. DELTA-MS > (vapor& moisture barrier, ° capillary break, drainage screen) Inner layer 2" XPS; Outer layer 1-1/2" Thermax; p D Seams staggered and taped. (air barrier & R-20 thermal barrier) D 777. 77D. ° ° D Waterproof Seam Tape(air&moisture seal) _. Crawl Space Foundation Pins Foundation Seal Tape s - " DELTA-MS to terminate intogU - ° ° f Existing Processed Stone D DrySpace 20-mil Moisture Barrier Felt 550 Crawl Space Underlayment °- Waterproof Seam Tape(air&moisture seal) Mill — DD ° .. ADS 14 Gallon Sum Basin u u p P a — a D rdopd.opd d,Screened -- ° Inlets —.-- ° A Di .° °7OG pdGv TM U Id -_- ........... - 111 - 11111 I 17 Flit ' ill 11111 1111 �. . l 111 1 llll_l l lull -. 1L 1- JOSEPH NELSON 1 PARALLEL STREET, SALEM, MA DI O BASNETT "Gilson ad., 5 "" . °' 978-952-2952s-9s2-z-zssz Scale: 1112"=14" OES GN 0U L) PEMODEL www$asnettDBRcom Stephen A Lovely, Esq. Lovely & Lovely 14 Story Street Salem, Massachusetts 01970-2820 Telephone 978-745-8274 Fax 978-745-6573 stephen,love(y@verizon.net James F. Basnett Jr. J.F. Basnett Company, Inc. 14 Gilson Road Littleton, Massachusetts 01460 RE: AUTHORIZATION FOR CONSTRUCTION AT PROPERTY LOCATED AT 1 PARALLEL STREET SALEM, MASSACHUSETS 01970 Dear Sir: I, Stephen P. Lovely am the owner of the property located at 1 Parallel Street, Salem, Massachusetts 01970.The property is currently under Purchase and Sale Agreement between Stephen P. Lovely, as Seller, and Joseph Nelson, as Buyer. A request has been made for my authorization as Seller to allow work to be performed by J.F. Basnett Company, Inc. on the property located at 1 Parallel Street pursuant to a contract with and on behalf of the Buyer, Joseph Nelson, prior to the sale of the property. The Seller, Stephen P. Lovely is not a party to the contract. That request to perform work is hereby granted under the following conditions: 1. Both the Buyer,Joseph Nelson and the contractor J.F. Basnett Company, Inc., agree to indemnify and hold harmless the owner, Stephen P. Lovely, from any liability or costs that result from the construction project between the buyer Joseph Nelson and attached hereto as Exhibit A. 2. No lien mechanic's or otherwise, shall be place upon the property under any circumstances by any party during the time of ownership of the Seller. 3. The contractor,J.F. Basnett Company, Inc., shall provide adequate certificates of insurance to the owner prior to commencement of the work. es F. BasnettJr. 5 hen P. Lovely ph Nelson J. . Basnett Company, Inc., November 12, 2012 CITY OF S.UEM, NLkSSACHUSETTS ButmiNG DEPAR NIENT • 120 WASHINGTON STREET, Yet FLOOR TEL (979) 745-9595 FAX(978) 740-9836 Kl,%(BERLEY DRISCOLL MAYORTHot`tAs ST.PfERRs DIRECTOR OF PUBLIC PROPERTY/BUISAJNG CONDUSSION€R Workers' Compensation insurance Affidavit: Builders!Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name 1RllainsssOrG+nizatioNlndividual): �cnc_�� C. 1r1C-. Address: �� 63%Assn City/State/Zip: t f A- o 4(, n Phone N: Are yyu an employer?Check the appropriate box: Type of project(requires: I. I am a employer with 4. ❑ 1 am a general contractor and 1 6. ❑Now construction employees(Fd11 and/or part-t me)' have hired the sub contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.) 7. ❑ Remodeling ship.and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. workers,comp.insurance. 9, ❑ Building addition [No workers'comp. insurance 5. ❑ We arc a corporation and its required] officers have exercised their 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 1 1.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Aaof repairs insurance required.]t employees.[No workers' 13 OtherJ/ \—�•_ _ comp.insurance required.] �\ 'Any appiicwtl dun chwka boa.VI Intal also fill Out the seeliet below showing Their workus'canprnsaliun policy:nturmalion. t 1 ton.owtro who submit this affidavit indi ting thcy an;doing all work awl 11100 hila etnside onfloactota moat acbtnit a now affidavit indicating such. =Cenlronon that chuck Ibis box man attached an additional Awl shnwing the name of the sub- ntrad.-wn and their workela'comp.policy inftxmation, I an;an employer that is pr oviding workers'coripensai.'an htsura rce jot my employees.. Below is rhe policy and job site information. A`l Insurance Company Name: f;Cts✓1 �J14_vfQfh^P C�M`�o../l� Policy 4 or Sclf-ins. Liv. N: L,)C— St-2�,3124 G Expiration Date: G--yam Job Site Address; �A(o`KI - City/State/Zip:-SA" . iM_& CA 1 -tom Attach a copy of the workers'compensation pulley declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 23A of MGL c. 152 can lead to the imposition of criminal penalties of fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to 5250.00 a day against the violator. De advised that a copy of this statement may be forwarded to the Office of Invcstigatiuns of the DIA for insurance coverage verification. I do hereby certTy pluder the pains and penaltiWerjury that the infbrmaidoo provided above'ss/rue and correc6 5i to pure' 1 -- Date. ZZ& 2-a/ Z Phon N: - Official use only. Do not write in this area,to be completed by city ae town oJrciai City or'ruwn: Permit/License N Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.Cityfrown Clerk 4. Electrical Inspector 5. Plumbing Inspector b.Other. _ Contact Person: Phone N: CITY OF SMENI, 1N'LkSSACHUSETTS a,, . BUILDIING DEPAR"I'NMNT 130 WASHLNGToN STREET, 3" FtoOR'i11- (978) 745-9595 Fns(978) 710-9846 IQ.,IiBERLF-Y DRISCOLL MAYOR T HoNtAs ST.PmRm DIRECTOR of PIBLIC PROPERTY/BU11DMG CON IISSIONER 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 111.5 Debris, and the provisions of MGL c 40, S 54; Building Permit # 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 I 11, S 150A. The debris will be transported by: (name of hauler] The debris will be disposed of in : _ling CP,n r- (name of cility ( ddress of facility) 'RVC�]f OAV 1��L.� l ignature of permit applicant t y zoiz to dcbd,�lydoc ACORD' DATE(MM DD Y VV) CERTIFICATE OF LIABILITY INSURANCE 07/17/2012 PRODUCER Phone: (978)562-5652 Fax: 978-562-7120 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION WELSH&PARKER INSURANCE AGENCY,INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 131 COOLIDGE STREET,SUITE 100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR HUDSON MA 01749 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: All American Insurance Company 20222 JF BASNETT CO.,INC. INSURER B: Commerce Insurance Company 34754 DBA BASNETT DESIGN/BUILD/REMODEL INSURERC: Central Mutual Insurance Company 20230 14 GILSON ROAD LITTLETON MA 01460 INSURER D: All American Insurance Company 20222 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD' TYPE OF INSURANCE POLICY NUMBEfl POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSR GATE MMIDO/YY DATE MMIDDIYY GENERAL LIABILITY CLP 8363144 07/16/12 07/16/13 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENreD $ 300,000 PFEMISES Eaocarenca) CLAIMS MADE❑ OCCUR MED.EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY r7 PRO LOC $ AUTOMOBILE LIABILITY BBHPHH 10/21/11 10/21/12 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) B X HIRED AUTOS BODILY INJURY $ X NONOWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ P AUTO ONLY: AGO $ EXCESS I UMBRELLA LIABILITY CXS 8363145 07/16/12 07/16/13 EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 C $ DEDUCTIBLE $ RETENTION$ Is WORKERS COMPENSATION AND WC 8363146 07/16/12 07/16/13 TJ RYTLIM TS OTHER EMPLOYERS'LIABILITY YIN E.L.EACH ACCIDENT $ 500,000 D My PROPRIETOR/PARTNEBIEXECUTIVE OFFICERMEMBER EXCLUDED) F I E.L.DISEASE-EA EMPLOYEE $ 500,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 SPECIAL PROVISIONS.1. OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION JF BASNETT CO.,INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ID DAYS DBA BASNETT DESIGN/BUILD/REMODEL WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 14 GILSON ROAD DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS LITTLETON MA 01460 AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE gcGH Attention: Karen Gedenberg ACORD 25(2009/01) Certificate# 49446 ©1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD i, Office of Consumer Affairs and Business Regulation F� 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement C4r4qor Registration Registration: 132490 '^ —� •. -- Type: Private Corporation Expiration: 2/15/2013 Tr# 208698 J.F. BASNETT CO. _INC - "-' JAMES BASNETT 14 GILSON ROAD 1 u LITTLETON, MA 01460 i Update Address and return card.Mark reasonfor change. I] Address. ❑ Renewal ❑ Employment Lost Card IiPs-CAI G.WMOb'e4G101216 ✓Re rCOIrNRdirL of /lq,�lddlN�tude� Office of Consumer Affairs&Business Regula Goa License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:,a�32490 Type: Office of Consumer Affairs and Business Regulation '- 10 Park Plaza-Suite 5170 Expiration 2MAZ013 Private Corporation �^ Boston,MA 02116 J.F.BASNETT 1 JAMES BASNETT 4Xt 14 GILSONLITTLETON,MA 01460 Undersecretary 4,,I.dth,,t signatur .Massachuselts- Department of Public SafclN Board of Buildim, Rc_ulatiuns and Standards (. Construction Supervisor License License: CS 43436 JAMES F BASNETT JR - 14 GILSON ROAD LITTLETON, MA 01460 -, Expiration: 7/1212013 f'„onni..b,oer Tru: 17696 i