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5 PHELPS ST - BUILDING INSPECTION �i � . o � C{ - l`I (p3 G� �- � S z15 'rhe Commonwealth of Massachusetts CITY OF Board of Building Regulations and Standards SALEM Massachusetts State Building Code, 780 CMR Revised blur 2011 Building Permit Application To Construct, Repair, Renovate Or Demolish a One-or Two-Family Dwelling s This Section For Official Only Building Permit Number: Date A plied c t Building Otlicial(Print Name). Signature D SECTION 1:SITE INFORMATION.' r 9P — —pe 1.1 Property Address: 1.2 Assessors Nlap& Parcel Number tJ1 1.1 a Is this an accepted street, yes ,no Map Number Parcel Number 1.3 Zoning Information: IA Properly Dimensions: Zoning District Proposed Use Lot Area(sq t1) Frontage(11) 1.3 Building Setbacks(R) 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: Zone: Outside Flood Zone? MunicipalO On site disposal system ❑ Public❑ Private(3 — Check If es❑ y SECTI/O'N2. PROPERTY OWNERSHIP,' 2f�1�O�wnQer�sof�RQec�ord; IA \Af��TT / I MA �t U )V "'"ty7,HStlatee,ZlP (]. No.mid Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORW(check PI that apply) New Construction❑ Existing Building❑ Owner-Occupied Erl Repairs(s) aK I Alterntion(s) ❑ I Addition ❑ Demolition ❑ Accessory Bldg.❑ Number of Units_ Other ❑ Specify: Brief D s�cri tion of Proposed Work': rf 1 C E / / SECTION 4: ESTIMATED CONSTRUCTION COSTS Itctu Estimated Costs: Oficial Use Only Labor and Materials I. Building $ Q 1. Building Permit Fee:S Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical S ❑Total Project Costs(item 6)x multiplier x 3. Plumbing S 1�4pQtherFees: S q. Nicchmtical (FIVAC) S - List: 5. Mechanical (Fire S 'total All Fees:S Suppression) 2 �,�.,�,^v Check No. Check Amount: Cash Amount: 6. Total Project Cost: $ / ✓I v V ❑Paid in Full ❑Outstanding Balance Due: �/ � M►all_ TO • Got3TQi�C. cacF— 7 Gf--�At—l_ uj V tKV—FlJk. •— vtz-V (3r-=�1_ vy—oy ) Teo or% S•�. SECTION 5: CONSTRUCTION SERVICES 5. Construction Supel isor License(CSL) .. �� dbect� /�Q License Number Expiration Date Nurse uff''CS [folder List CSL'rype(see below) / A2�1� Sing 'fype Description No.and Street Unrestricted(Buildings up to 35,000 cu. tt.) • C, R Restricted 1&2 Fmnil Dwelling Cuyjown,State ZIP M Nfasonry -^ RC Roofing Covering _ INS Window and Siding .J SF So lid Fuel Burning Appliances ' 1t/' 31 a- b�( 1 Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(HIC) _ I IC Registration Number .xpimtion ate HIC Comp:NN�.a for HI Re is tName ll�: i � No. and Strc T—, Email address Cit /Town,State,ZIP 1 0 Iffyiephone SECTION 6:WORKERS'CbMPENSATION 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 IsSuanc of the building permit. Signed Affidavit Attached? Yes .......... No........... 0 SECTION 7u:OWNER AUTHORIZATION,TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACiTOR AP B PEJES'FOR BUILDING PERMIT' I,as Owner of the subject property,hereby authorize 1/ l O— t� oC OA�'7/ [<cJ t9 act on my behalf,in all matters relative to work authorized by this building permit application. 0not 0wncr's Name(Electronic Signature) ate SECTION 7b:OWNEW ORAUTHORIZED AGENT DECLARATION By entering my name below, 1 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. t�J1� 25 Print owner's or,\uthonzed Agcnus Name(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 air have access to the arbitration program or.guaranty fund under NI.G.L.c. 142A. Other important information on the HIC Program can be found at www.rnass.,ov:'oca Information on the Construction Supervisor License can be found at www.masi.,ov-!dILi 2. When substantial work is planned, provide the information below: 'total fluor area(sq. R.) " :(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 ofhalflbaths Type of heating system Number of decks/porches Type ofcoolin.g system Enclosed Open_ i. "total Project Square Foota.ge"miry be substituted tar"Total Project Cost" QTY OF SALEM, MASSAC HUSEM i' jPt BUILDING DEPARTMENT 120 WASERNGTON STREET,31D FLOOR TEL. (978)745-9595 FAX(978)740-9846 KIMBERLEY DRISCOLL MAYOR THomAs ST.PIERRE DIRECTOR OF PUBLIC PROPERTY/BUILDING 00AWSS1011JER Construction Debris Disposal (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 c40, 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 deposit 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 facility) uvA —{ (address of facility) Signature of applicant Date 00, CITY OF SALEM, NL—ksS:1CHUSE"ITS BuI DI\GDEP.1tRT> EV IT 3120 %VASHNGTON STREET, 3'a FLOOR "ILL (978) 745-9595 Eta(978) 740-9846 KINt8 Rf FYDRISCOLL %-,1AYOR THO,%W ST.PIERRE DIRECTOR Of PUBLIC PROPERTY/BUI DING CO\LMISSIONER ?Yorkers' Compensation Insurance Aftidrvit: Builders/Contractors/EJectricians/Plumbero Applicant Information /1 lrl�Please Print Legibly VBtnelnusiltussOrganirati)m'individual): 1�'A. sry l / 1l—), RC��/�l t. Jr1,1��,�, Address: �iTC2PeT- City/StatclZip: 1 Ph0neN:�oL'Y-3la -�N©r Are yl un employer'?Check file appropriate has: je Type of projoet(required): 1. I am a employer with 4, ❑ I am a generalcontractor and b. ❑New construction employees(full and/or pan-time).• have hired thcontractors 2.(] 1 ran a sole proprietor or partner- listed on the d shecL t 7. Remodeling ,hip anJ have nu employees These sub-coors have 8. ❑Demolition workinglitr me in any capaci[y. wokers'comurance. ), Building addition INo workers'comp. insurance 3. ❑ Weare a corpn and itsrcquin d.Jofficers have sed their 10.❑Electrical repairs or additions 1. i um a homeowner doingall work right nl exemer MGL I L❑ Plumbing repairs or udditioru myself.(No workers'sump. c. 152, q I(4), e have no 12.❑ Roofrepairs insurance required.) 1 employees. (Nkers'camp. inuranuired.j 13.0 Other 'Any upplicaan Out chucks boo el most also rollout the sectiun blow showina their woden'eompeamli n policy infrrmallon. 'I Tomeuwm",0a tuhmit this alnrinvis indicating ihry are damg all work and then him outside eaninetan moat m,hmil a nuts anidavit indicting such. $'omrwtum thus chak ibis bus mot anach al un addittorul ahnl showing The nano oftho sub4anincton and their workers'camp.policy information. /am un rurpJuyer that h pruvidhrK workers'rumpauallan i+rraruuee jot my crop/uyers. ltelov is dia pa//ty and Jub ails in ornratinn. Insurance Company Name: ^ . I. �lll . 111(� Policy;;or Self itu. Lic. 4: `�°S.J� - /TEI rgn Date:­/0 Job Silt Address: � !"_ S/O l FCC I Cily/Stara/Zip: ,%ffach a copy ur the woriters'compensation pulley declaration Page(showing the pulley number and expiration date). Failure to secure coverage as required under Section 25A uf,LIGL c. 132 can lead to the imposition oferiminal penalties of a line up to SI.500.00 und/or one-year imprisnnmcn4 as well as civil penalties in the form of o STOP WORK ORDER and a line of up To 5250.00 a day against the violator. Be advised that a copy of this statement may be rurwarded To the Office of Li vesligmi°ns ul'Ihe OIA fur insurance coverage verification. - /du hereby erdiy r l to ahts mad penaldes of perjury Mal the infurutuffa+s provided ubuve is True an "Orr".& Si••n t c: �_ I- IVV Phoned Of icial use only. Do nor write in lhi.v area, ro be cunspleled by city ur/owns o ltlut City or Town: _ ._ Permit/I.lcenseq__.._..__. .--- Issuing Autlmrily(circle one): 1. Board of 1leulth 2. Building Depastutcia .1.f"ityfrnwu Clerk J. Electrical Lupcctur 5. Plumbing Inspector b. Other i Cunluct Perron: Phone .' _ I Classic Construction Builders Inc. 10-15-14 Brian Courtney 978 325 1305 Bob Hebert 617 312 1407 8 Harris Street Beverly Ma. 01915 Licensed and Insured Job Location-Cavanaugh Residence 5 Phelps Street Salem Ma.01970 Estimate for redecking and replacing two 10"x96" columns on deck in front of house Remove all old decking,replace any deteriorated framing members Install temporary supports to remove existing columns to be replaced with new structural columns Install new t&g composite decking ,with hidden stainless nails Second floor gutter to be removed for exterminators and then reinstaled Any deteriorated trim will be replaced with Azek composite trim boards All debris from job to be disposed of at local transfer station Labor and Materials $13000.00 Terns of payment- one third at start of job-second third at end of first week-last payment when job has been completed If you wish Classic Construction Builders to proceed with this estimate please sign below and return to Classic Construction Builders at 8 Harris Street Beverly Ma. 01915 f Signature ✓ � a Date Respectfully Bob Hebert �1 Brian Courtney �i A�a CERTIFICATE OF LIABILITY INSURANCE DAT11061D/14 „/O6/2014 THIS CERTIFICATE IS 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 the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement- A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT HeatherATenney Thomas St Jean Insurance NAME: 484 Lowell St IN"C"o . 978-531-8053 FAX No: 978-531-8653 Suite 1-C E-MAIL s: heather@stjeaninsurance.com ADDRE Peabody, MA 01960 INSURERS AFFORDING COVERAGE NAIC p INSURER A: TRAVELERS CASUALTY&SURETY CO OF IL 19046 INSURED CLASSIC CONSTRUCTION BUILDERS,INC. INSURER a: AIM 23140 8 A HARRIS ST Beverly,MA 01915 INSURER C: INSURER D: INSURER E: INSURER F: 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 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL$UBR POLICY NUMBER MMIDDY� MMIDD/NYYY LIMITS A GENERALUABILITY 168047DOX056 02/10/2014 02/10/2015 EACH OCCURRENCE IS 1,000,000 DAMAGE TO COMMERCIAL GENERAL LIABILITY 300,000 PREMISES Ea occurrence $ CLAIMS-MADE M OCCUR MED EXP(Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per acadent) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Peraccidenl UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DELI I I RETENTION$ 1 $ B WORKERS COMPENSATION AWC-400-7031790-2014A 10/23/2014 16/23/ 0015 wC STATUS CEH- AND EMPLOYERS'LIABILITY ANY PROPRIETOWPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 It es,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 1e1,Additional Remarks Schedule,it more space is required) CERTIFICATE HOLDER CANCELLATION Fax#: (978)745-0058 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SALEM THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10 CONGRESS STREET ACCORDANCE WITH THE POLICY PROVISIONS. SALEM, MA 01970 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD t �\ Office of Consumer Affairs&Business Regulation ME-IMPROVEMENT CONTRACTOR egistration 165688 - Type: xplrabon ,.3118l2016 Private Corporatir 1 CLASSIC CONSTRUCTION BUILDERS INC. i tE i ROBERT�4BERT \ L8 HARRIS ST j BEVERLY,MA 01915 Undersecretary E: Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License. CS403594 r IN ROBERT P HEBE$T ` 8A HARRIS STREE k1Tj BEVERLYMA6191 % )i s Expiration i - Commissioner 07/09/2015