3 PARK ST - BUILDING INSPECTION t i
I � The Commonwealth of Massachusetts
Board ot'Building Regulations and Standards CITY
OF SALEM
Massachusetts State Building Code, 780 CMR, Tn edition
r Revised Jurnrury
Building Permit Application To Construct, Repair, Renovate Or Demolish a /• =001V
One-or Two-Fumily Dwelling
[ Tths Section For Official Use Only
Building Permit Numpen Date Applied:
i
Signature:
Building mis ioite/Inspector of Buildings Date
SECTION 1:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map& Parcel Numbers
1.1 a Is t is an accepted street?yes no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq 11) Frontage(it)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required Provided Required Provided Requirci Provided
1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
Zone: _ Outside Flood Zone? Municipal❑ On site disposal system
❑
Public❑ Private❑ Check if es❑ P po y
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner of Record:
LSO Af-Q1O F cel�►J�°lSC2� �.9iC/- S'T2E �7` S is
Name(Print) Address for Service:
978 -2� - 537a
Signature Telephone
SECTION 3: DESCRIPTION OF PROPOSED WORW(check all that apply)
New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg.❑ Number of Units_ Other Specify:
Brief Description of Proposed Work-: S?'2� SC,R7-t2
P4,9
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
Labor and Materials
I. Building S I. Building Permit Fee:S Indicate how fee is determined:
❑Standard City/Town Application Fee
2.Electrical $
❑Total Project Cost (Item 6)x multiplier x,�,�
1. Plumbing S 2. Other Fees: S
4. Mechanical (HVAC) S List:
5. Mechanical (Fire S Total All Fees: S
Su ression
d aeJ Check No. Check Amount: Cash Amount:
6.Total Project Cost: S �� ❑Paid in Full 0 Outstanding Balance Due:
(� t
SECTION 5: CONSTRUCTION SERVICES
5.1 Licensed Construction Supervisor(CSL) CS/6/96!�F
`'i�/I �57 OiOff6�L- /e , aLvt/LS� License Number f. pi IUn 1)atC
NjMcul'CSI -Ilol er
List CSL Type(sm below)- (J
,^ s ryae Description
U Unrestricted(up to 35,000 Cu.Ft.
Restricted 1&2 FamilyDwelling
Si alum `D �+a M Maso Unl
RC Residential Rooting Covering
Telephone WS Residential Window and Siding
SF Residential Solid Fuel Burning Appliance Installation
D Residential Demolition
5.2 Registered H me Im rovemeot on ctor(HIC) 6
HI Compare Name or if egistrant Name Registration r'
97e ;7 elQ-O/Q/ . pirmi Date
Signature Telephone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e. 152.1 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 Issuanc.o4thc building permit.
Signed Affidavit Attached? Yes .......... No...........❑
SECTION 7s: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.
Signature of Owner Date
/J SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION
- ro(OGd2S �� ,as Owner or Authorized Agent hereby declare
that the statements and information on the foreg ing application are We and accurate,to the best of my knowledge and
behalf.
Print N
Signdturif6f Owner or Auflwfized Agent Dat
Signed under the pains and penalties of 'u
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 WJ have access to the arbitration
program or guaranty fund under M.G.L.c. I42A.Other important information on the HIC Program and
Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 1 10.116 and 1 IO.RS, respectively.
2. When substantial work is planned,provide the information below:
Total floors 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 half7balhs
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"
i
RAPID ROOFING
GENERAL CONTRACTING CO.
P.O. BOX 605 SALEM , MASS. 01970
978-740-0101
MASS LIC # 128253/144946/CS101965
RAPID ROOFING IS A DIVISION OF COYNE&SONS CONTRACTING CO.
ARCHITECTURAL SHINGLE ROOFING ESTIMATE
TO. 5/31/2010
LEO FRANCISCO
3 PARK STREET.
SALEM, MASS. 01970
978-210-5372
JOB SITE ADDRESS.
SAME
RE; ROOF ESTIMATE # 010-082
COMPLETE STRIP (1 LAYER STRIP) OF A SLATE ROOF (20. SQ)
INSTALLATION OF 30 YR ARCHITECTURAL ASPHALT ROOFING SHINGLES -
ON ENTIRE MAIN HOUSE ROOF OF THE BUILDING..
WE AGREE TO.
l. COMPLETELY STRIP THE ENTIRE MAIN HOUSE ROOF OF ALL THE
EXISTING ONE LAYERS OF SLATE SHINGLES ON THE ROOF OF
THE BUILDING AT THE PRESENT TIME.
2. REMOVE ANY ROTTED ROOF DECKING BOARDS OR SHEATHING ON
THE ROOFS OF THE BUILDING, AND INSTALL UP TO 100 FT.OF EITHIER
ROOF BOARDS OR SHEATHING- FREE OF CHARGE ( ONLY IF ROTTED
AREAS ARE PRESENT).
3. INSTALL NEW WATER&ICE SHIELD ON THE FIRST THREE FEET OF THE
MAIN ROOF OF THE PROPERTY. ALSO ON ALL RAKE AREAS, VALLEYS,
DORMERS, CHIMNEYS, OR FLAT ROOF AREAS OF THE ENTIRE BUILDING.
4. INSTALL NEW 15 LB. ASPHALT FELT ROOFING PAPER ON THE
ENTIRE MAIN ROOF OF THE PROPERTY..
5. INSTALL NEW 8 INCH ALUMINUM DRIP EDGE ON THE
ENTIRE MAIN ROOF OF THE PROPERTY.
6. INSTALL ALL NEW VENT PIPE BOOTS ON THE MAIN HOUSE ROOF
OF THE BUILDING AS NEEDED.
7. INSTALL NEW ALUMINUM STEP FLASHING ON ALL AREAS OF THE
COMPLETE JOB AS NEEDED.
8. INSTALL NEW 30 YR.. ARCHITECTURAL ASPHALT ROOFING
SHINGLES AND CAP ON THE ENTIRE MAIN HOUSE ROOF OF THE
PROPERTY.
9. REMOVE AND INSTALL NEW LEAD FLASHING ON THE EXISTING MAIN
HOUSE CHIMNEY OF THE PROPERTY.
10. REMOVE THE EXISTING SKYLIGHT ON THE RIGHT SIDE OF THE
BUILDING, AND INSTALL TWO NEW VELUX SKYLIGHTS ON THE
RIGHT&LEFT SIDES OF THE MAIN ROOF OF THE BUILDING.
11. INSTALL A NEW RUBBER ROOF ON THE FRONT BAY ROOFS OF THE
BUILDING.
12. WE AGREE TO REMOVE ALL ROOFING DEBRIS FROM THE PROPERTY.
TOTAL COST OF JOB..................................$ 8,400.00
WE HEREBY PROPOSE TO FURNISH ALL MATERIALS AND LABOR-COMPLETE IN
ACCORDANCE WITH THE ABOVE SPECIFICATIONS FOR THE SUM OF....
$ EIGHT THOUSAND FOUR HUNDRED DOLLARS-$ 8,400.00
WITH PAYMENTS TO BE MADE AS FOLLOWS....................
$ 4,200-00 DOLLARS DOWN/ $ 4,200.00 TO BE PAID IN FULL UPON THE
COMPLETION OF THE WORK....
NOTE-THIS PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED WITHIN---21 DAYS.
ANY ALTERATION OR DEVIATION FROM THE ABOVE SPECIFICATIONS
INVOLVING EXTRA COSTS,WILL BE EXECUTED ONLY UPON WRITTEN ORDER,
AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE ESTIMATE.
ALL AGREEMENTS ARE CONTINGENT UPON STRIKES,ACCIDENTS,OR
DELAYS BEYOND OUR CONTROL.
NOTE; WE CANNOT ACCEPT ANY RESPONSIBILITY FOR ANY DAMAGES.OR DEBRIS FALLING INTO ATTIC AREAS,
CUSTOMERS SHOULD COVER VALUABLES,GREAT CARE WILL BE USED TO PROTECT THE EXTERIOR STRUCTURE
BY COVERING THE EXTERIOR WALLS,OBJECTS,AND FOLIAGE WITH TARPS TO HELP PREVENT ANY DAMAGES
DURING THE STRIPPING OF THE ROOF,HOWEVER SOME DAMAGE AND MARRING COULD OCCUR BEYOND OUR
CONTROL,
HOMEOWNERS MUST MOVE ANY VALUABLES AWAY FROM THE BUILDING,PRIOR TO THE STRIPPING OF THE
ROOF.
NOTE; IF MORE LAYERS OF ROOFING MATERIALS ARE FOUND THAN INDICATED ABOVE IN THE ESTIMATE,THE
OWNER OF THE PROPERTY WILL BE IMMEDIATELY NOTIFIED,THE OWNER ACCEPTS ALL RESPONSIBILITY,AND
(AGREES)THAT,ANY EXTRA CHARGES WILL BE ADDED FOR THE LABOR AND THE REMOVAL OF TILE EXTRA
DEBRIS,OVER AND ABOVE THE PRICE OF THE ESTIMATE....
NOTE. IF FINAL PAYMENT HAS NOT BEEN RECEIVED OR PAID IN FULL AT THE TIME OF
THE COMPLETION OF THE WORK, AS OUTLINED IN THE CONTRACT,AND RESULTS IN ANY
TYPE OF COURT ACTION.. THE OWNER OF THE PROPERTY OR CONTRACTOR OF SAID JOB.
OTHER THAN RAPID ROOFING COMPANY AGREES TO PAY ALL COURT FEES,ANY
ATTORNEY FEES,AND INTEREST OF 12%COMPOUNDED EACH MONTH.,ON THE FINAL
BALANCE OWED TO RAPID ROOFING CO.
ACCEPTANCE OF PROPOSAL
THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS
ARE SATISFACTORY AND ARE HEREBY ACCEPTED.
YOU ARE AUTHORIZED TO DO THE WORK AS SPECIFIED.
PAYMENTS WILL BE MADE AS OUTLINED ABOVE..
DATE OF ACCEPTANCE
SIGNATURE
SIGNATURE
SIGNATURE
PLEASE MAKE ALL CHECKS PAYABLE TO
CHRISTOPHER R. COYNE SR.