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17 CENTRAL STREET - BUILDING JACKET 1 k The Commonwealth of Massachusetts ^ ® Department of Public Safety J` Massachusetts State Building Code(780 CMR) Building Permit Application for any Building other than a One-or Two-Family Dwelling `r"n I (This Section For Official Use Only) Building Permit Number: Date Applied: Building Official: SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street ad4044 is not av ' e) IC4 7 C> 17 No.and Street City/Town Zip Code Name of Building(if applicable SECTION 2•PROPOSED WORKarn Edition of MA State Code used 20 If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair grl Alteration ❑ 1 Addition❑ I Demolition ❑ (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify: Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural Engineer' g Peer Review required Ye I ❑ No ' 'ef description of Proposed W rk: M�`-+� ,T `'1 '� k t d+ •clr IYi c L. ails iv,A. SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDMON„OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): I Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq.ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1 ❑ F2❑ 1 H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ 1: Institutional I-1 ❑ I-2❑ I-3❑ I4❑ M: Mercantile❑ R: Residential R-10 R-2❑ R-3❑ R4❑ S: Storage S-1❑ S-2❑ U. Utility❑ Special Use❑and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as applicable) IA O IB ❑ IIA O IIB ❑ IIIA O IRB O IV ❑ 1 VA O VB O SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Suppl . Hood Zone Information: Sewage Disposal: Trench Pe'� -I. Debris Removal: Public Check if outside Flood Zone Indicate municipal r A trench ;—of be Licensed Disposal Site Private❑ or indentify Zone: or on site system❑ required or trench or specify: permit is enclosed❑ Railroad right-of-way/ Hazards to Air Navigati MA Historic Commission Review Process: . Not Applicable Is Structure within airport ap oach area? Is their review completed? or Consent to Build enclosed❑ Yes❑ or No f5� -Yes❑ No ❑y _ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: • Occupant Load per Floor: Does the building contain an Sprinkler System?: Special Stipulations: t�At� � o c, •�- � ( 1Z SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owne, ` , / /fYyPJM FPX CCN1eQ0 ( /CC/tlfz. ) J+ ti� S' e l✓1 Name(Print) No.and Street City/Town Zip Property Owner Contact Information: Mina me 6i:n -Civ- Title Title Telephone No.(business) Telephone No. (cell) e- ail addres IE applicable,the property owner hereby authorizes - A-Jame Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this budding permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) F building is less than 35,000 cu.0.of enclosed space and/or not under Construction Control then check here O and skip Section 10.1 //10.1 Registered Professional Responsible for Construction Control l7rnr` Jb Namg. gistram) Telephone No. e-mail address Registration Number 7 I Le x � /�nxt r,�� M� ZV OiGi Street Address City/Town State Zip Discipline Expiration Date 10.2 General Contractor A66o4 6a1)-f)4/uGA;tq4 L u-c //Company Name l'Nit1x� R�bT7 Name YPerson Responsible for Construction License No. and Type if Applicable Po Gait q!6 60A)ri A& 0 Street Address City/Town State Zip 4.,45 -_ Ab6C4+consfw !onMti�Uerr . Telephone No.(business) Telephone No. celle-mail address SECTION 11:WORKERS'COMPENSATION INSURANCE AFFIDAVIT M.G.L.c.152§25C(6)) A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes❑ No ❑ SECTION 12:CONSTRUCTION COSTS AND PERMIT FEE Estimated Costs:(Labor Item and Materials) Total Construction Cost(from Item 6) 1.Building $ ''lj Q Building Permit Pee=Total Construction Cost x_(Insert here 2.Electrical $ appropriate municipal factor)_$ 3.Plumbing $ - 4.Mechanical (HVAC) $ Note:Minimum fee=$ (contact municipality) 5.Mechanical Other $ //``^ Enclose check payable to 6.Total Cost $ V t./ (contact municipality)and write check number here SECTItvli3:SIGNATURE OF BUILDING PERMIT APPLICANT By entering my name below,I hereby_..est under the pains and penalties of perjury that all of the information contained in this application is true and accurate to to best of my knowledge and understanding. Please rmt and sign name Title Telephone No. Date Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: Name Name 1 Date CITY OF S.U.&M. N'L-1SSACHUSEM • BUILDING DEPARTMENT 130 WASHINGTON STREET, Yo FLOOR TFL (978) 745-9595 FAX(978) 740-9846 KI-,{gERLEY DRISCOLL MAYOR T7H01`tAs ST.PIERRE DIRECTOR OF PUBLIC PROPERTY/BUILDIING COMNaSSIONER 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 111, S 150A. The debris will be transported by: A�a C��svl'en L a ,P �� IaL-L (name of hauler) The debris will be disposed of in : yvoa Co (name of fac 13 1®c�Im•tcQ P��k �� Pew ' /1'Jj�, Qi�i66 (address of facility) Sig a re of permit applicant date dcbriviT.d(w The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations I Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information )- Please Print Lesibly /�1� Name (Business/Organization/lndividual): /^I�iT'j] 1tUl tt0'� (� �✓IG� �IJll�l� L.L-� Address: P d &)O el- City/State/Zip: City/State/Zip: d okG M MA c Phone#: 'q7'8 - W 7 -G545 Are y an employer? Check the appropriate box: Type of project(required): 1. 1 am a employer with_C 4. ❑ I am a general contractor and 1, 6. E]New construction employees (full and/or part-time).' 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. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. o workers' com right of exemption per MGL y [N p. 12.[] Roof re8a-irs insurance required.] t c. 152, §1(4),and we have no i� employees. [No workers' 13 Other 1�t t)•. O comp. insurance required.] ey+pn or 'My applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit thi aaffidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. %Contractors that check this box most attached an additional sheet showing the time of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site information. +/ / Insurance Company Name: We;, �t'O✓at _fA`JU'ni''16e- Policy#or Self-ins. Lic. #: n Q QE-(',V Trj05 I Expiration Date: Z4/66A7// Job Site Address: 1 y Gen4y-11 64 City/State/Zip: //c t r✓n K 0 A 7 6 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si nature: y Date: �y 012 Phone#: / p,� / ' %9 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Massachusetts Department of Public Safety Board of Building Regulations and Standards P (lwontrieoierneo�/l r� li lm�rrlrlh License: CS-032850 Office of ConsumerAttairs&Business Regulation Construction Supervisor ME IMPROVEMENT CONTRACTOR I _ glstratlon 176206 Type: GARY B ABBOTT xpvahon 7/29/2017 *- individual P.O.BOX 99 'tu sy,.t BOXFORD MA 01921 GARY B. GARY ABBOTT �_ x; •-' -� r . 7 TOWNE RD '�- � q„2L_ • ..nn l.� } Expiration: BOXFORD,MA 01921 Undersecretary Commissioner 12/23/2017 y I It U.S.Daw nent of Lab& 0=00cmal Safety and Health Administration yf ft•e, d GaryABbott has Sucneas/ully pomplofetl a 30 hour Occupaw as Sata a x Tramnp� Course In x'�" b aM HaBlh xa Ef�+ar} e _: 0 "' o _ o Construction &. %Landscaping LLC 7 Towne Rd Boxford, MA 01921 978-767-5545 Fax 978-887-3087 Contract for Landscape THIS AGREEMENT, made this 6th day of May, 2016, by and between Museum Place Condominium, hereinafter called the Owner and Abbott Construction & Landscaping LLC, hereinafter called the Contractor. In Consideration of the agreements herein contained, the parties, hereto mutually agree that for the sum of$3,888.43 payable in two(2), the Contractor agrees to furnish all labor, materials, equipment and all else required to perform and complete the work as set forth under Section A of this agreement.. Abbott Construction will provide proof of the following insurance coverage: Worker's Compensation as required by Massachusetts General Law Property & Casualty minimum $1,000,000.00 SECTION A — Service Specifications Demolition -Contractor will remove and dispose of existing concrete stairs Labor - Contractor will provide all labor for the installation of concrete footing to set granite on - Contractor will provide all labor for the setting of granite stairs and well as reinstallation of existing cast iron railings Contractor will provide all Patching of sidewalk to correct final grade 1 Granite Stock Side Stairs -12in x 5.5ft x 7in step -18in x 7ft x lin step Staging Police Detail -Cost per day for Salem Police detail (required for work on sidewalk) Safety Equipment -Installation of temporary fencing and sidewalk staging Parking Permits -Cost per day for parking space blocking for job access Building Permits -Cost for permit to install in stairs and sidewalk blockage SCHEDULE A-100 Abbott Construction & Landscaping LLC is not responsible for buried material and/or unsuitable soil on property not visible at time of estimate Abbott Construction & Landscaping LLC is not liable for the following items listed below -Special order granite prices quoted will be honored for 90 days -Any damage to building that is currently obstructed from view. -Existing cast iron railing found unusable due to change in grade to meet building code -Will not guarantee removal of concrete step pocketed into building until ruled as non- structural. -Removal and disposal of any buried unsuitable materials Abbott Construction & Landscaping LLC will remove and store cast iron railings on property during renovation of stairs. No modifications of railings will done till granite stairs are complete. Abbott Construction & Landscaping LLC will install new granite stairs to meet all building code requirements. Abbott Construction & Landscaping will remove railing and install railing but is not responsible for the modification or welding of the railings. Payment Schedule 15` payment— $1,944.21 One month before start of project 2nd payment—$1,944.22 Balance due upon final walkthrough A c cel')I ed by: Authorized Representative Date Scott Abbott Date Abbott Construction& Landscaping LLC President � T- I- TV CA { � i � , � 1 , I I � Std ; ►' + ! ± i ► { ! � � I � I � _ i _ �_j_ � � � s- ~ i � � i CqU � I- �I ,� i- 1 - � ,- �Ivtl��•i'�i� ��- i- . -- 17 - - - - -- - ..._ IJi eip 4 • —�. n _ 1. _ .— ., _ .�. _ 1 _ 1 _+ —.T r- ,, _. ....4. .h �� —T_�_-n�. l I t—7 4 - - . - F + . ..:._ .. _ . t. _ , _ 1 +. . r . � . � _ ;. _ 1. _ ..� -t'- '- +- �- - .t. 1 � *- + -t -1-r-*---r•--1- - + - -� - r I 1 _ {- 'i- -i —y.v .-- _.. .-+ ; -Y I. i - Y � -r— • —.4.-�._ .t. .. _ � - "{ ` .�. - 1'_'�—i�---4-�--i—.T � 't + -r—'t 1 i l _ t F .•. •.i { -r—f` • _ —.. - .*_ _ j _ q..- .. nom_- 4-"t _-I` .4 �. 1 �_ Mit •-- -.•t-- - ;—_ — .. �:... +� +-��,.TT ^�— .L— � _.. .. '� - -. , —.1. . .� T — 1 -+- It 1 , I t- - Y..-#--I----'.�-t - - a- r �-+-•r---f---�•�--�-- -t -r -',' TI-r-'•i---f--!-�r t 4- . yam..-,.._-t__•_ ( _+- , _ .: ._ .. _..,.._.�.__--�� ---r-- �'r -+--�=�--�--i'- '-a- { - �- - - --E --+ _.�'_+ -�_'-�--t _.<._'� . T jam. ttII , I 1 __». --t- r t-4-- I -} - 1. 1 I 1r l N K 4Y !rJ 9� d AL / Yr•y { a r � , AIrA 2 \ / . CIL . e : . =a � ;- ' �/D 5 � ) C�-?C� VfD. �� The Commonwealth of M��t�i��' � Department of Public Safety � �"' ,' ��,�ss�,�n�5��s�;,<<a��Kc��tc��OFSr4�6 30 A S 2b . ^ Building Pemiit Application for any Building other than a Onr or'Crvo-Family Dwelling U ' � ,(This SecNon Fur Official Use Onl ) 6uilding Permit Number. Date Applied: Building Official: � ! SECTION 1:COCAT[ON Please indicate 61ock ri on1 Lot k for locations for which a sheet address is not available) ` � � t le,.� I 7D . �I No.�md Street(lYf!� �z. City/Town Zip Code Name uf Building(if npplicable) ' (� SECI'ION 2 PROPOSED WORK � fV I � Editiun of MA State Cude useJ_ If New Cunstructiun check here O or check all that apply in the two rows below Existing 8uildin� Repair❑ Alteratioi Addi[ion� Dcnwlition O (Plc.ise fill uu[�md submit Appendix t) Change of Use ❑ Ch�mge uf Oca�panty ❑ Other ❑ Specify: Are building plans�md/or cunstruction ducuments being supplied as part of this permit applic.ition? Yes ❑ No ❑ Is an(ndependent Structurat Engincering Peer Rev'ew required? Ycs No ❑ Orief Descriptio -of Propused Work: a � SECiION 3:COMPLETE TFIIS SECTION IF EXISTING BUILDING UNDERGOING 2ENOVATION,ADDITION,OR � CHANCE IN USE OR OCCUPANCY � � Chcek here if an Exisfing Building Investigatian and EvaluaHon is enclos��1(See 7S0 CMR 34) ❑ EsistingUseCmup(s): -` ProposedUseGmup(s): � SECIION 4:OUILDING HEIGFIT AND AREA � Existing ProposeJ Nu.of Fluors/Sturies(include basement levcls)&Area Per Fluor(sq. ft.) � Tu[al Are�i(sy.ft.)and Total Height(ft.) SECTfON 5:USE GROUP(Check as a plicable) A: Assembly A-I❑ A-2❑ NighMlub ❑ A-3 ❑ A-k 0 A-5❑ B: Ousiness ❑ E: EducaHonal ❑ F: Facm F-1❑ . .F?❑ IL• Hi h Hazud H-1 � H-2❑ H-3 ❑ H-�{❑ H-5❑ h Institutional f-I❑ I-2❑ t-3❑ f-�k O Nh hlercanHle❑ R: Residential R-10 R-2❑ R-5❑ R-0❑ i S: Storage SI❑ S4❑ U: Utility❑ Special Use O and please describe bduw: ' . Speci�il Use: SECTION 6:CONSTRUCTION'I'YPE(Check as a licable) � IA ❑ IU ❑ lfA ❑ IIU ❑ If1A ❑ ❑10 ❑ IV � Ve\ ❑ V6 ❑ SECTION 7:SITE INPORMATION(refer to 78U CMR 111.0 for deWils on each item) Water Supply: Flood Zone Information: Sewage Disposal: Trench Permit � Debris Remuval: A trench will nnt be Licensed Dis usal Site❑ Public� Check if uutside Flood Zune❑ Indicate inunicipa� required b3 ur trench ur specify� ,.��/.aM � S�. Privafi❑ - m indentify Zone: or on site systcm O vinnit .�s endnseJ ❑ . 'Railroad righbof-wa : liazuds to Air Navigation: �i\.i,�ut i i � unmi� i n I �ie`!'.I r .ei.ss: Nut Applicable� Is Structum within airpurt appronch area? [s thur review completeJ� ar Conscnt to 13uiIJ c�idused❑ Ycs O or Nt Ycs❑ No � � SECTION H:CONTENT OF C•RTIFICA'CE OF OCCUPANCY � 1=ilitinn uf Cnde: ,Usc Group(s): �fypc of Cunstructiuit:_ Ocnipant LoaJ per Ilaur:. __ Uucslhcbuildingiuntain.mSprinklcrSysteml: _ Spccial5lipulelions� --- , � SECTION 9: I'ROPERTY OWNER AUTHORIZA"fION � N;ime nnd Addrrss of�Property Owner . ., , , -�:� L �a I� M/� O l�ZO ��.,,I�C.Pa2T`-Q�� . Name(Print) No.ind Street .�N�t� (� City/Town Zip Pruperty Owner CunWct f�fqrmatioq: � ,.:•7 � ��---- ��,��t.-/a� Tille Telephone No.(business) Tclephone No. (cell) rmail mlylreysst,--�,/, If applicable,the property owner hereby authorizes ��J� �h Name StreetAddress City/To�m State Zip tu act on the ro er uwner s behalf,in all matters mlative to wnrk authotized b this buildin ermit a lication. " - SECTION 10:CONSTRUCTlON CON'CROL(Please fill aut Appendix 2) � ; If buildin is Iess thnn 35,000 cu.tt.uf endosed s ace and or nat under Construction Control then check here 0 and ski Section I01 I0.1 Re istered Professional Res onsible for Construcfion Control � Name(Registnnt) Tclephone Nu. e-mail,iddmss Registration Number Strret Address City/Tuwn State Zip Discipline Expirafion Date 10.2 General Conhatfor - � - a//ar� �`u;�J•s ' , CamNlny N. ie � � . . . � � . �a��! /a//e�^� /_'S - 0 9 i 337 Name of Perso�n�esponsible fur CnLonstruction License No. and Type if Ap licable /79 /✓aS/�1.�410� :ZZ ' /o�SF/lc� �` 0�983 Strcet Address � City/Town , State Zip 'fcic hone No. business Tcle hone No. cell e-mail addmss SECTIONI1:lVURhERSCOAIP6N5r1P1C)illNtiUlt:\aVCE:\I'I'IUr\VI�I' M.C.L.c.152. 75C6 A 1Vorkers'Cumpensation Insurance Affidavit from the MA Deparhnent of[ndustri.il Accidents must be mmpleted and submitted with-this application. Failure to provide this affidavit will rcsult in the denial uf the issuance of the building permit. Is n si ned Affidavit submitted with this a lication? Yes❑ No O SECI'ION 12 CONSTRUCTION COSTS AND PERb1IT FEE ��` Eslimated Costs:(Labor -- anS M�i[crinls) Total Cons[ructiun Cust(from Item 6)_$ 1. Uuilding � 6uilding Permit Fee=Tutal Construction Cost x_(Insert here 2.Electrinl 5 appmpriate municipal factor)_� t. Plumbing 5 d. �ledianical (HVAC) $ Nute:Minintum ke=$ (mntnd ntunicipality) 5. blechanical Other `6 C•ndose d�cck a -�ble W 6.Totat Cus[ ��y� �� (contact inunicipality)and write check number here SECTION 13:SICNATURE OF 6UILDING PERfotIT APPLIG�NT 6y enteruig my name beluw, 1 hercby attest uuder the pains and penal[ies of perjury that all of the informatiun contained in this apNlic�tion is We and accumte to the best of my knowledge and understanJing. �N /�/�,✓ or✓� 9� ggr �6 3/, Ple.�se pri�[and s'g i nni��_ Tide Tclephune Nu. Date Slrcet Addms � � C' y Town Sta[e Zip i� Alunicipal 6ispector to fill uut this section upon application approvaL• - "+� � � <� Name Datc ; � /� ��J : 4% , � Tlie Con:monwealth ofMassachusetts � !� DeparlmentoflndustrialAccidents :! --� J � 1 Congress Street, Suite I00 � Boston,MA 02I14-2017 � e www mass.gov/dia �\'arkers'Compensation Insurance Af£davit:Bailders/Contrac[ors/Electricians/Plumbers. TO BE FILED WiTA THE PERMITTING AUTHORITY. Applicant Intormation Please Print Leeiblv � N8ri10 (Business/Organization/Individual): %,g/�hl,t'�n/ �Ui�� Address:_ /7� /✓�"cs`i��n'�*cn e(fi • City/State/Zip: � o SF/EGD Phone#: 97�'�f'17'33�G Areyou au employer?Check�theapprapriate box: Type Orprojec[(requil'ed): L�a employer with J employees(full and/or part-[ime).' �, � W COPS[iUCIIOP 2.�I am a sole proprieror or partnership and have no employees working for me in $, �mOde�ing any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.�f am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10 �Building addition � 4.�I arn a homeowner a�d will be hiring contractors to wnduc�all work on my property. I will � ensure that all contractors either have workers'compensation insurance or are sole 11.�EleCh'iCal LepaiSs or additiolls pmpriemcs wi[h no employees. ' 12.�Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors lis[ed on[he attached sheet 13.�jZ00f iCpd175 These sub-conhactors have employees and have workers'comp.insurance.I � 6.�We are a corporation and its officers have exercised their right ofexemption per MGL c. �4.❑�t}1B7 I52,§I(4),and we have no employees.(No workers'comp.insurance required.] *Any applicant that checks 6ox#I mus[also fill out lhe section below showing iheir workers'compensation policy information. t Homeowners who submit this affidavit indica[ing[hey are doing all work and Ihen hire outside contracrors mus[su6mit a new affidavit indicating such. IConhactors that check this box must attached an addi[ional sheet showing the name of the sub-conhactors and s[a[e whether or not those entities have employees. If the sub-contracmrs have employees,they mus[provide[heir workers'comp.policy number. I aar an employer that is providiiag warkers'compensatian iasurance for my employees. Be[ow is the policy and job site informafion. �/ Insurance Company Name: �/Ld6� 1iy3"• . Policy#or Self-ins.Lic.#: On.�37//07 D / Expiration Date: / // Job Site Address: �7, ir.?��/� City/State/Zip: .y �� 97� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$I,500.00 and/or one-year 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 this statement may be forwarded to the Office of Imestigations of the DIA for insurance coverage verification. I do hereby ceKi- under! pains and penalties ofperjury that the informa[ion provided above is true and correc[. , / / Si2nature: //AN�� Date: �/S Phone#: � � �7� ' g��3c3� Official use only. Do not write in this areq to be completed by city or town ojficiaL City or Town: Permi[/License# � lssuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: f. , 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,partnership,association,coiporation or other legal entity,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 aparhnents and who resides therein,or the occupant 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 shall not because of such employment be deemed to be an employec" MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commouwealth for any applicant who has not produced aceeptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states`Neither the commonwealth noc any of its politica]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 contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking 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(I.LC)or Limited Liability Partr�erships(LLP)with no employees other than the members or pariners,are 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 Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign a�d date[he aflidavit. The affidavit should be retumed to the city or tovm that the application for the pernti[or license is being requested,not the Deparhnent of . Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Departmen[at the number listed below. Self-insured companies should enter their � self-insurance license 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 Investigations has to eontact you regarding the applicant. � Please be sure to fill in the permitAicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current � policy information(if necessary)and under"Job Site Address"the applican[should write"all loca[ions in (city or town)."A copy of the affidavit that has been officially stamped 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 licenses. A new affidavit mus[be filled out each year.Where a home owner or citizen is obtaining a license or pemvt not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The DeparhnenYs address,telephone and fax number: - The Commonwealth of Massachusetts Deparhnent of Industrial Accidents i 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. #617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Rev;sed oz-z3-15 www.mass.gov/dia t- ✓" ' C[TY OF SALEM, MASSACHt7SETI5 ';� j , BUILDINGDEPARTMETTI' ` � 120 WASHIIVGT'ON S7REET,3AD�,OpR 7�L.(978)745-9595 KIlvIBERLEYDRIS�LL FAx(97S)740-9846 MAYOR 'h3oNrns ST.P�xxE DIItEGTOR OF PUBIdCPROPERTY/BUII,DING ODMIvII$$fONER Construction Debris Disposa/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 c40, 5 54; Building Permit�1 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. 7he debris will be transported by: _ � yr��.as�> /�/�rT� I (name of hauler) ! The debris will be disposed of in: (name of facility) - �� as�f �� (address of facility) �� Si at re of applicant �� Date `I�- i s- i s-� � /�/�'�� = f F��T � � C��l/T� L. � T �L��1 � � .S,�GOlV�..� a�',.r_.OD/Z F-6I32u�},�Y 2s Zc�ls i V V ��C �� I I � � � f , � , �/Z.. I' �1!/ST/Jt/!'i , �//�1K I EX/ST//VG . _ �y/� c� � � � . � �X/S TINGr I .5�`IOW,�'lp. I P � I ie , � � � � ��/1/10V� : !N� L L � rs -' O � rvsTqr�- /-�� L � i� ��ti�t sft�� . �,fiw I��2Y�2 M U�A/T � �O t - � - - - - - - - - - - - - - - -• - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - Dt�i�lJ� � �op:N�w W�t�L ,�X/STI��a ,��v ��NI � U� v _ : , � �— -- — . __ ____ _�__ I _. � � j ,�� = l�o�T r 7 ��,��. 5T S��.�� r-�2s �- �LODjZ ��=��-� � zs- zors �/�-� R � 1�I , � � � � � �i � � � �� k l� sTi�-iRw�-y �-�� v� U� � � rHrs s��c.�- � � � '� � � � � � : c`�l � �. 3 6" '`� 3 5 /�'� —��- � � � R.E�2�-M� � �� T �_ �\ ' � , �/1/101/�� z„�„j W � , �X/S?1^/G.-�- R.�MDv�; � Hft� �= ��;rN �X/STi�t./G� � : t�/�sH-FR. 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L� V,EL �X/ST/NC� /�y�S[� !3/�-JUS7Ei�= � Sl� l�/� 1�/ ��--�� . . � - _ _ , _ --- ft � . .�; to . The Commonwealth of Mas;sachusetts Department of Public Safetpa JOL 25 A 152 Massachusetts State Budding Code(7 1 Building Permit Application for any Building other than a One-or Two-Family Dwelling (This Section For Official Use Only) . Building Permit Number: Date Applied: Budding Official: P3 �fe V SECTION 1:LOCATION(Please indicate Block#and Lot#for locations for which a street address is not available) 17 Ce,,4ce4l 4,S4 , IVA nigf -) II No.and Street City/Town Zip Code Name of Building(if applicable) \ SECTION 2-PROPOSED WORK. Edition of MA State Code used_ If New Construction check here❑or ch k all that apply in the two rows below Existing Building❑ Repair❑ 1 Alteration ❑ 1 Addition❑ Deigolition (Please fill out and submit Appendix 1) Change of Use ❑ Change of Occupancy ❑ Other Specify:..� Q_ Are building plans and/or construction documents being supplied as part of this permit application? Yes ❑ No ❑ Is an Independent Structural Engineering Peer Review requ' ed? i \ Yes ❑ No cj Brief Description of Proposed Work: n eJ( p-qtxske / i N i 1 .l0 SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,ADDITION,OR CHANGE IN USE OR OCCUPANCY - Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CMR 34) ❑ Existing Use Group(s): Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq. ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as applicable) A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A4❑ A-5❑ 1 B: Business ❑ E: Educational ❑ F: Facto F-1❑ F2❑ H: High Hazard H-1❑ H-2❑ H-3 ❑ H-4❑ H-5❑ I: Institutional 1-1❑ 1-2❑ I-3❑ 14❑ M: Mercantile❑ T R: Residential R-10 R-2❑ R-3❑ R4❑ S: Storage S-1 ❑ S-2❑ U: Utility❑ Special Use CI and please describe below: Special Use: SECTION 6:CONSTRUCTION TYPE(Check as a plicable) IA ❑ 1110 IIA ❑ 11B ❑ IIIA ❑ IIIB ❑ IV ❑ VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Su Flood Zone Information: Sewage Disposal: Trench Permit: Debris Removal: - A trench wyr not be Licensed Disposal Site Public Check if outside Flood Zone Indicate munkimil required 2 or trench or specify: Private❑ or indentify Zone: or on site system❑ permit is enclosed❑ Railroad right-of-wa Hazards to Air Navigation: MA i n t rlc Co,nausioo Re � . I �x� s: Not Applicable Is Structure within airport appr ,ch area? Is their review completed? or Consent to Build enclosed ❑ Yes❑ or No E Yes❑ No ❑ SECTION 8:CONTENT OF CERTIFICATE OF OCCUPANCY Edition of Code: Use Group(s): Type of Construction: Occupant Load per Floor: Dues the build big contain an Sprinkler System?: Special Stipulations: �Ptl-lam Ff(2.. 7JAIDllv Z-vx Z9 SECTION 9: PROPERTY OWNER AUTHORIZATION Name and Address of Property Owner 17 F,e846d Sk I P4✓! PIA Olq-) l Name(Print) No.and Street City/Town Zip i P operty Owner Contact Information: tillo Telephone No. (business) Telephone No. (cell) Ma address applicable, the property owner hereby authorizes rune Ij Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized by this building permit application. SECTION.10:CONSTRUCTION CONTROL(Please fill out Appendix 2). f budding is less than 35,000 cu.ft.of enclosed-space and or not under Construction Control then check here❑and skip Section 10.1 10.1 Registered Professional Responsible for Construction Control - - ar�j A,66ft CI7M-F1Q- ao5 �b�ofl3� ver; I 6 �06 Name( gistrant,� A Telephone No. U-mail address Re istratfon Number -7 ��le, Imo, 1'��xFan�' M 61Q'LI ' _ 11 Street Address City/Town State Zip Discipline peat on Date 10.2 General Contractor - A6b� LLB, ?11pany x1q 6bo44 - 11- 93, 201:7 Name oof- erson Responsible fur Construction /j . pLicense No. and Type if Applicable 1 �— 01-06c. RA I�GJC�ci rcx Street Address City/Town State Zfp 78.767 6r,y5 q iao5 Qoab6:>*' ,� ✓C� nr`Zo�. Tele hone No. business Tele hone No. cell e-mar address SECTION 11:41'C?I:KEILS'COfvIPENS,1'I[ON INSURANCE:4GFIU;4Vf1' M.G.L.c.152§25C6 A Workers'Compensation Insurance Affidavit from the MA Department of Industrial Accidents must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the i uance of the building permit. Is a signed Affidavit submitted with this application? o 13 SECTION 12:.CONSTRUCTION COSTS AND PERMITFEE Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)_$ 1.Building $ Building Permit Fee=Total Construction Cost x (Insert here 2.Electrical $ appropriate municipal factor)_$ 3. Plumbing $ d. Mechanical (HVAC) $ Note: Minimum fee=$ (contaa',t municipalit; 5. Mechanical Other $ Enclose check payable to ��GG)) 6.Total Cost $ ` (contact municipality)and write check number here SECTIO 13:SIGNATURE OF BUILDING PERMIT APPLICANT 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 a best of my knowledge and understanding. Please print and sign name Title Telephone No. Date Street Address City/Town State Zip Municipal Inspector to fill out this section upon application approval: L�Zr"w'� ,1�4 9A1I Name Date CERTIFICATE OF LIABILITY INSURANCE °A06P2442016 YY) 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 have ADDITIONAL INSURED provisions or 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 endorsements). PRODUCER NAMEALT JoyceMKeller PHI Garden S resDTarlce,Inc. - PHONE FAX 27 Garden Street (978)7744338 zi 15 lac,No):(978)7741318 Unit 113 aoDnEss: IoK'eCD?Philrichardinsurance.com Danvers,MA 01923 INSURER(S)AFFORDING COVERAGE NAICR INSURER A: Safety Insurance Cc 39454 INSURED Abbott Construction&Landscaping LLC INSURER B: Safety Indemnity Ills CO 33618 PO BOX99 INSURERC: The Hartford Insurance 19682 BoQord,MA 01921 wsuRERo: Mesa Underwriters Specialty Ins Co 3E838 INSURER E: RSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IKSURED 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. INSR ADOL SUOR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER (MMMOrfYYY 4MMMDNYYYUMITS A COMMERCIALGENERALUABILITY Y BMA0025191 041OW016 0410812017 EACH OCCURRENCE $ 1,000.000 CLAMSMADE 12 OCCUR OAMAGEREM D PREMISES Eaoxurren S 100.000 MED EXP M ore rson $ 5,000 PERSONAL S ADV PLLRY $ 1,000,000 GENL AGGREGATE LW APPLIES PER: GENERAL AGGREGATE S 2,ODO,ODD POUCY [0Xa 0 LOC - PRODUCTS-COMTYOP AGO $ 2,000•000 OTHER: $ B AUTOMOBILeuiest ITY 5059193 CWOWM16 (WOM17 OhEMNE s EL1W S 1,000,000 (Ea accident) ANYAUTO BODILY rJL1RY IPar Person) $ OWNED SCHEDULED ANDS ONLY AUTOS BOOBY flLLRX2Y(Per accident) S JHRED / NOKOWPED PROPERWO MAGE $ AUTOS ONLY V AUTOS ONLY Per Wtlant A IUMSREual.lAe J OCCUR Y C00025191 04/08/2016 04/08/2017 EACH OCCURRENCE $ 1,0001000 EXCESS INB CLAPASMAOE AGGREGATE $ 1,000,000 DED RETENTION$10,000 $ C WORNERSCOMPENSATION 08WECVT5051 04/06/2016 04/0612017 PER OTH ANDEMPLOYER5UABILRY YIN STATUTE R ANY PROPRIETORIPARTWIVIXCUTIVE E.L.EACHACGDENT S 5DO,000 FFICERJMEM EXCLUDED? N/A 500,000 (M 1 rY ) EL.DISEASE-EA EMPLOYEE $ I es,tlescribe under 500,000 DESCRIPTION OF OPERATIONS bebw E.L.DISEASE-POUCYLIMR $ D Commercial General Liability Y MPOO20003001704 12/10/2015 12/10/2016 occurrence:$1,000,000. Snow RenDlel Operations Lggregate:$2,000,000. DESCRIPTION OF OPERATONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule.my be attached It more space Is Mgptredl - Certificate holde and Ddtlen Company are included as additional insured(s) Win respect of General Liabllityas required bywritten Contract and/or agreement. Emailed to:niamoureux@DOLSEN.com CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR—REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD SRA May 11, 2016 Page 1 of 9 4 .f City of Salem Massachusetts Public Meeting Minutes Board or Committee: Redevelopment Authority, Regular Meeting Date and.Time: Wednesday, May 11,2016 at 6:05 pm Meeting Locations 120 Washington Street, Third Floor Conference Room Members Present: Vice-Chairperson Grace Harrington, Conrad Baldini, Robert Curran,Matthew Smith,Russell Vickers Members Absent: None Others Present: Lynn Duncan,Andrew Shapiro Recorder: Colleen Anderson Vice-Chairperson Grace Harrington calls the meeting to order. Roll call was taken. Urban Renewal Area Projects Under Review 1. 24 New Derby Street(Artists' Row): Discussion and vote on"Mural Slam" concept. Deborah Greet,the Salem Public Art Planner,was present to present the "Mural Slam" concept. Greet stated that the Salem Arts Festival is scheduled for June 4`h-6 h. The back of the buildings along Artists' Row are blank walls. Mural slams are paintings that last two days. The walls themselves will not be painted. 4x8 pieces of plywood will be primed,attached to the walls, and murals will be painted on them. 10 artists have submitted applications so far. When driving by it is not apparent that this is a place for art and these murals will call attention to this area. If it becomes popular it can be done every year. Baldini asked how long the mural will stay in place and noted that the rain will warp the plywood. Greet replied at least through October. The mural surface will be treated to help them last, these boards are smaller so they could bend more,but alternate plywood options are being considered. Shapiro stated that public art projects go straight to the SRA and the DRB does not review them. SRA will approve it as a'concept proposal and the Public Art Commission will also review it. Greet stated that the PAC has already reviewed and approved the project. Vickers: Motion to approve the"Mural Slam"concept. Seconded by: Curran,Passes 5-0. Shapiro recommends that the SRA grant approval is based on the granting of a variance by the ZBA. Duncan approved of the inclusion of that stipulation to tie the two approvals together. Baldini: Motion to approve as recommended by the DRB, conditional upon the granting of a variance by the ZBA. Seconded by: Vickers,Passes 5-0. 4. 17 Central Street(Residences at Museum Place): Discussion and vote on proposed replacement of three sets of entry stairs. Tracey Rubin, James Warren, &Patrick Eddy—Board Members of 17 Central Street were present to discuss the replacement of the three entry stairs. Eddy stated that they are looking to upgrade all three sets of stairs that are concrete and deteriorating. Eddy added that they would like to replace them with granite stairs, to make them meet code which they currently do not, and to reuse the existing railings and they are working with the General Contractor to make sure that happens. ' Shapiro stated that DRB recommended approval as presented. Vikers: Motion to approve as recommended by the DRB. Seconded by: Curran. Passes 5-0. 5. 283R Derby Street(Notch): Discussion and vote on proposed outdoor seating area(cafe permit review) Chris Lohring owner/president of Notch Brewing was present to discuss the proposed outdoor seating area. Lohring stated that they have an application for a permitting path at Notch Brewery. Shapiro stated that the DRB unanimously voted to recommend approval of the outdoor seating area,but there were some aspects to the plan that Chris will be returning to the DRB for review and approval on. LED parking lot lighting and goose neck lighting were not considered by the DRB in their review. The seating, wood fence,bench arrangement, style of bench, and umbrellas were included in their approval recommendation. Vickers stated that this application came to them approximately 6 months ago regarding a sign at the rear of the building. Lohring replied that that sign has been removed and this is a separate permitting path and he will be meeting with the ZBA in a week, so he will be returning to the SRA for signage approval. Shapiro stated that this approval request is for the patio area only. When Chris returns to the SRA he should have already been granted approval by the ZBA for signage and lighting. +9 . .. r ..n &'+ w.1��'' ate."Z� r.�a•�� T•ys...n.q�`. .'T't' " 1`0sHA , f 600002871 7 ' i� Yy a5 Us,Department of Labor Occupational Safety and Health.Administottwn- ' Gary.Abbott `" f has s.sceasfusy completed a 30+hour Occupaaonal Salery eM Haeah e `T&ining Course In ' �= �, •, Consouclion Safety&Health x x Massachusetts Department of Public Safety + ' Board of Building Regulations and Standards License: CS-032850 Construction Supervisor GARY B ABBOTT P.O.BOX BOXFORD MA 01921 't '•^'� vim— Expiration: Commissioner 12/23/2017 r� Q� rpr Affairs&BuC�aei,Re moatiem Office of Consumer Affairs&Business Regulation ME IMPROVEMENT.CONTRACTOR istration: �1 08. Type: EVXp iration: ��=7=� Individual f. GARY B.ABBOTT .=Qt al �i GARY ABBOTT 3; 7TOWNERD. � y. + BOXFORD,MA 01921 "- '�� ;'' Uoderseeretary �' F , A Construction & Landscaping LLC 7 Towne Rd Boxford, MA 01921 978-767-5545 Fax 978-887-3087 Contract for Landscape THIS AGREEMENT, made this 6" day of May, 2016, by and between Museum Place Condominium, hereinafter called the Owner and Abbott Construction & Landscaping LLC, hereinafter called the Contractor. In Consideration of the agreements herein contained, the parties, hereto mutually agree that for the sum of $26,180.77 payable in two(2), the Contractor agrees to furnish all labor, materials, equipment and all else required to perform and complete the work as set forth under Section A of this agreement.. Abbott Construction will provide proof of the following insurance coverage: Worker's Compensation as required by Massachusetts General Law Property & Casualty minimum $1,000,000.00 SECTION A - Service Specifications Demolition -Contractor will remove and dispose of existing concrete stairs Labor - Contractor will provide all labor for the installation of concrete footing to set granite on I 1 Contractor will provide all labor for the setting of granite stairs and well as reinstallation of existing cast iron railings - Contractor will provide all Patching of sidewalk to correct final grade Granite Stock -Main Stairs Right Side -AR x 9.5ft x 7in landing -12in x 9.5ft x 7in step (four) -12in x 1 1 ft x 7in step -Aft x 7in filler (two) -5ft x 7in filler (two) -6ft x 7in filler (two) -7ft x 7in filler (two) -8ft x 7in filler (two) Main Stairs Left Side 4k x 9.5ft x 7in landing -18in x 9.5ft x 7in step (two) -18in x 1 1 ft x 7in step -oft x 7in filler (two) -5ft x 7in filler (two) -6ft x 7in filler (two) 1 Staging Police Detail r -Cost per day for Salem Police detail (required for work on sidewalk) Safety Equipment -Installation of temporary fencing and sidewalk staging Parking Permits -Cost per day for parking space blocking for job access Building Permits -Cost for permit to install in stairs and sidewalk blockage SCHEDULE A-100 Abbott Construction & Landscaping LLC is not responsible for buried material and/or unsuitable soil on property not visible at time of estimate Abbott Construction & Landscaping LLC is not liable for the following items listed below -Special order granite prices quoted will be honored for 90 days -Any damage to building that is currently obstructed from view. -Existing cast iron railing found unusable due to change in grade to meet building code -Will not guarantee removal of concrete step pocketed into building until ruled as non- structural -Removal and disposal of any buried unsuitable materials Abbott Construction & Landscaping LLC will remove and store cast iron railings on property during renovation of stairs. No modifications of railings will done till granite stairs are complete. Abbott Construction & Landscaping LLC will install new granite stairs to meet all building code requirements. Abbott Construction & Landscaping will remove railing and install railing but is not responsible for the modification or welding of the railings. Payment Schedule 1" payment - $13,090.38 One month before start of project 2"d payment - $10,000.00 At start of second stair demo 3rd payment - $3,090.38 Balance due upon final walkthrough Accfp ed by: m �a AtMorized Representative Dat �d Scott Abbott Date Abbott Construction & Landscaping LLC President On OFSALEK ALMAtHMETP' Bt1IxmDzPA 120 WiuFmYc7MSn1Wr,9mFLoart nL OM)N5.9595. FAx 74498I6 BII�ERIEYDdZISC]OZb ) AYQR 7�ioiuSST.P�tRB DntacrcitcFpumucpxcmm/BLu1 amaamc R Construction Debris DisposaiAffrdavit (required forall demolition and.renovation work) in accordance with the sbtth edition of the State Building Code, 780CMR, Section 111.5 Debrk, and the provisions of MGL cw, S 54; Building Permit#1 is Issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste deposit facility as defined by MGL c 111, S 1WA. The debris will be transported by. A6ho-t} Cons4ruyE1"6n (name of hauler) The debris will be disposed of in: �Jo6ck Truc,i !C.) .Dc_ (name of facility) 3 U1<e1rr\S pk�e 0 - Pe lxll MA 0l9 (0 (address of facility) Signat a of applicant � _ Date The Commonwealth ofMassaehusetts Deparbnent oflndusbiafAccidents I Congress Street,Suite l00 Boston,MA 02114-2017 WlVWmass gov/din Workers'Compensation Insurance Affidavit:Builders/ContractorsMectriciam/Plumbers. TO BE FILED WTFR THE PERAff TiNG AuTRORITY. Applicant lntormstion Please Print Leelbly Name(Businnness/OMiazzatimJlodividuso: N '�' 1 ) ( J_C. .. Address:_ City/State/Zip:�X�V M4 0111.a Phone#:_q 7$ -76 7 (5t.(5 A an employer?Cheek the appropriate box: 171n a employer with E of project(squired): employees(fall and/or pan-time).• 2-0 I am a ask proprietor m pamtetahip and have no�Joyep construction any capacity svokea'comp.announce tequbed,J `VOtI°°g forme in sling 3.0]me homeowner doing all wok myself.(No workers'comp.insurance required.)t molition 4.❑1 am a homeowner and w>ll be hiring eonuwm m conduct aU wok m my propeay. l wrll ilding addition emurc the all contractors either have wsnkers'mwmpensetion insurance or are sole ctrical repairs or additions proprietors with no employees. s. 1 am a nbing repairs m additions ❑These sub-contragws he.•eod I have hired thenubcontractorslistedontheattached sheet.employees and have woken'comp.msmaucei ofrepairs6.❑We era a corporation and in officeshaveexercisedthetrright of eamption per MGL c. er 15Z 61(4),and we have no employees.(No woken'comp.insurance requved) *Any applicant that checks hoot al must also fill our the section below showing their workers'compansation policy information. Homeowma who submit this affidavit indicating they eo doing all wink and than hire ohmide emtractors mast submit a new affidavit indicating such tConaactors that check this box must ateched an adktional sheet showing the mine of the rob-contractors and sate whether or not those antitim bave amployees lfthe aub"cmmasms hm empbycM they must provide their workers'comp.polkynamber. I din an earployer,that is providing workers'compensation tune ncefor try employees. Below is thepoll y and job site Information � ) insurance Company Name: HC,l�•�'�f.Q Policy#or Self-ins.Lic.#: V7 CE05 I Expiration Date: t Z6 Job Site Address: I—7 CA A(\eA, GSty/Statemp: '� n�J✓I Attach a copy of the workers'compensation policy declaration page(showing the policy number and explirration date). Failure to secure coverage as required under MOL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year i'Prisonalent,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 this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby a under lhepatas andp es dfperjuty that the information provided above Is tree and correct S' store ate e#- QOOwW use only& Do not write in this area,to be completed by city or town official City or Town: Permit/Ltcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact 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,partnership,association,corporation or other legal entity,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 apartments and who resides therein,or the occupant 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 shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of 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 political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking 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 Partnerships(LLP)with no employees other than the members or partners,are 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 Department of Industrial Accidents for-confirmation of insurance coverage. Also be sore to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the approunate 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 evert the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current 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 stamped 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 licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or perunt to bum leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02 1 14-20 1 7 Tel.#617-7274900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mws.gov/dia 1 , ;O!ac � �+ - woe T - .-a- 7'171 _ �- 47 - ! -i , { , . 91 ! r r - } it 444, _t. + r r1. - IJ -t- -4- I - y -1--}- - - JI I ilq ti � a 4. 'Am !� ➢+p �"3 « . Xm r 5 i D I y, +� r r �! .4 a i , ' 4 • . t � 1 J • 1� i I ! _... Y 1 • -1 0._ -1 The Commonwealth of Massachusetts L.j Department of Public Safety .'; ,\Iassdrhusctls State Building Code(7811 C'\IR) s , ` Building Permit Application for any Building other than aOne-or Two-Family Dwelling (Phi+Section For Official Use Only) Building Permit Number: _ Date Applied: _ Building Official: SECTION 1: LOCALiON(Please indicate Black 8 and Lot q for locations for which a street address is not available) No. and Street City /Town Zip Code. Name of Building(if applicable) SECTION 2:PROPOSED WORK Edition of\IA Slate Code used If New Construction check here❑or check all that apply in the two rows below Existing Building❑ Repair❑ 1 Alteration ❑ Addition❑ Demolition ❑ (Please fill out and submit Appendix I) Change of Use ❑ Change of Occupancy ❑ Other ❑ Specify:— _ Are building plans and/or construction drxvutents being supplied as part of this permit application? Yes ❑ No --- ls an Independent Structural Engineer�}}��Peer Review required? Yi's ❑ No ❑ Brief Dcscri,tiunofProposet�,Wurk:�'j8✓SICU C_ �✓�-' 1�✓L _ f 0o4 CQV� f t r SECTION 3:COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATION,AUDITION,OR CHANGE IN USE OR OCCUPANCY Check here if an Existing Building Investigation and Evaluation is enclosed(See 780 CNIR 34) ❑ Existing Use Group(s): _. Proposed Use Group(s): SECTION 4:BUILDING HEIGHT AND AREA Existing Proposed No.of Floors/Stories(include basement levels)&Area Per Floor(sq, ft.) Total Area(sq.ft.)and Total Height(ft.) SECTION 5:USE GROUP(Check as a licable) A: Assembly A-1 ❑ A-2❑ Nightclub ❑ A-3 ❑ A4 ❑ A-i❑ B: Business ❑ F.: Educational ❑ F: Facto F-I ❑ F2❑ N: Hi h Hazard H-1 ❑ H-?❑ H-3 ❑ H-4❑ li-5❑ 1: Institutional 1-1 ❑ 1-2❑ 1-3❑ 1-4❑ XI: Mercantile❑ R: Residential R-113 R-2 Cl R-.i❑ R4❑ S: Storage S-1 ❑ S-'_❑ U: Utility❑ Special Use❑and please describe below: Special Use SECTION 6:CONSTRUCTION"TYPE(Check as applicable) -IA ❑ IB ❑ IIA ❑ 1113 ❑ 1 IIIA ❑ IIIB ❑ IV ❑ 1 VA ❑ VB ❑ SECTION 7:SITE INFORMATION(refer to 780 CMR 111.0 for details on each item) Water Supply: Flood Zone Information: Sewage Disposal: 'french Permit: Debris Removal: Public❑ Check if outside Flood Zone❑ Indicate municipal ❑ A trench will not be I_iconsed Disposal Site❑ required ❑or trench drspecify:___"______ Private❑ or indcnlily Zone: or on site system ❑ permit is enclosed❑ Railroad right-of-way: Hazards to Air Navigation: ,— Not:Applicable❑ Is Structure within airport apprnerh,rea? Is their review complcicki or Cntscnt to Build enclosed ❑ '1 vs❑ or No❑ YCs O No Cl SECTION N:CONTENT OF CERTIFICATE OF OCCUPANCY Edition c il.Code: -___ L'sCGruup(s), 1q,vol Construction: . _ Occupant Load per Floor. Ihus lhr building;ciuuain au til,rinklor Svsnm?: � tiprcial stipulations: "_" -.. _ ___---___ _...__ _ . . . 7Y �T. SECTION 9: PRoPi:.R'TY OWNER AU I'IIORIZATION N',n ,e and Address of�P`roperly Owner kue> ems e riL�LW�O_�rc. \T G�1T' — \`fit•^, Name(Print) No.and Street City/Town Zip Pofa�iQwq�6,vw ict Information: 6 "Title relephone No.(business) Telephone No. (cell) e-mail address If applicable, the property owner hereby authorizes Nano Street Address City/Town State Zip to act on the property owner's behalf,in all matters relative to work authorized b this building permit application. SECTION 10:CONSTRUCTION CONTROL(Please fill out Appendix 2) If building is less than 35,000 cu.ft.of enclosed s ace and or not under Constnaction Control then check here Cl and skip Section 10, 10.1 Registered Professional Responsible for Construction Control Name(Registrant) Telephone No. e-mail address Registration Number Street Address' ,City/Town Stale Zip Discipline Expiration Date 10.2 General Contractor S q� ,>n �j any Naafi g�C 1 • Name of er on Res m s1 ible f. COr&ction �� License No. and Type if Applicable �� t © Street Address - City/Town Atate Zip 6300 C??9� 26 e39g yele-r •W�ck,W eov-(C,-T n�- Tele phone No. business Telephone No. cell a-nail address SECTION 11: 7IRKIaR5f'( 0%1i•tNSArIt Vvt;51Jl:n_uC A1H11AVlf M.G.L.c.152.§ 25C6 A Workers'Compensation Insurance Affidavit from the h9A Deparhuent of Industrial Accidents 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. Is a signed Affidavit submitted with this application? Yes❑ No ❑ SECTION 12.CONSTRUCTION COSTS AND PERMIT FEE ' Item Estimated Costs:(Labor and Materials) Total Construction Cost(from Item 6)=S 1. Building S Building Permit Fee=Total Construction Cost x_(Insert here ? Electrical S appropriate municipal factor)_"r 3. plumbing 5 a. Mechanical (HVAC) S Note: Minimum fee=S (contact municipality) 5. Wchanic.d Other $ I Enclose check payable to - 6.Total Cost $ (contact nnmicipality)and %%rile check number here SECTION 13:SIGNATURE OF BUILDING PERMIT APPLICANT Be enic•rin, my nano below, I hereby attest under the pains and penalties of perjury that all of the information nntainod in this aI) lion true and accurate to G ac bes t of my know ledge,uui wnderstanding. \\ V D c C. \ I'k as•print a xl sil;n naay`e\\�J�> \ �f") .� title �. . cph�i qp ) Date - -14/15L Lj- ---- - - -"`--J -— ------ - - 1 0 titrcet .-Address City/row❑ SI, te• Zip Q Municipal Inspector to fill out this section upon application approval: Name Dale 7 I a CITY OF SALEM PUBLIC PROPRERTY i' DEPARTMENT \I+1r 41 SI:1C!)' $,111•N, M.1\1.11.111 %I I Workers' Curnpeniatlon Insurunce 1fOdlnit: Uuilders/Cuntnctur>r/!le trlchtns/Ylumben � ) decant (,Ifonntttlo t I \I;IITIC IILwIIe IyI)rgmlr�linrvinJl��\d\uull: Int Le 'hl\ cily,.selre Zip- 1 .\r�ry ruu an enlployvr'1 Cheek the:lpproprlat ,box: 1.%:l :un 4 vmplu)vr wilh 1QL 4, Cl la'"a general cautraelor and 1 t yPe o(prlt)vet(reyulred):' enrpluyete(lull m1Uur part•tinw).• have hind the suh•cun(racWrs ❑New cunstruelluo 2• 1 aura solo prnprienn nr partner• listed on the attached.vheet t ship and have no vm lu vest y ❑Rernlsdeiin� P Y 7liesa subconlraerars hove working tin no in any capacity, o'orken'comp, insurance. d Cl Demolition I Kra workers'cutup, insurance J. ❑ we are a cooperation and its 9, Cl ouildind additiun required.) )tyrcers have vwni.rud their IQ.C]ElectrieW repairs or 4dditions 1.❑ 1 ant A homeliII Juing all work right of exdnlption put KI 11.0 PlumbinY mpuirs or additions myulL INO ivarkvrx'comp• C. 152. I(i),and we have no nsurance required.) 1 npluyete.INO workers 12080lil'npuirs eoonp insurance nyuind.) 110 Othar •'�,1/•Hphcae m,a chehe twr wl Ima.Ilw fill uu IM vrchwl Iwtuw dwwule Ihyo wwklee'sunryenualwl Idiey ndurwtertw� 'I Io'nvllwlwO who odlnlir Ibis•Illdavll indtealine INV 41e Juin 4.MII;wuln thlll lMrk this box rota anxhwl,In addatIIIIIIIIIIIIIIIIIIIIIilililllllllllllllllllillillillillillilliillillillillilliillillililllllllllllllIlImyl, e ill wu�11w IMw AMt uwlidt eullrlw 1Wo1 dluwin the naow of the lax•ee/e1 T"•r it a raw alnderil inJilylnx.tw'A•rewle aM1 IAea wuhere'ratty,P+Iky mlMnuriva or am un autployrr/her lr pros/J/ne worhai'rurnprnrallon Ltlantnrejur/wy crap/uyerr• Br/utv i'y/Aiierlpsy end/ul.lih iujunnulhtla C a Insurance Company Nnmt V'\•SC.O`� �`�/\C Policy 4 or Salf•ins. Lie.toL'1.1�1.?C�nI.Q Eapirarwn Job Site -lddnssj� �T� Utaeh is cagy of Ilse workers'eumpensatlnn p„llvy duclrrallun pugs(showing the policynuluplty a pl►aHua dote), itllluw II Iccuro coverages i required wlJcr Scuiun'!A of JIOL e. 112 e44 lead to the impusitian ol'eriminal penalties o/a 1)ne tyt or Sl.Wl J y Idai una•year imprisownent, as well as civil Iscnaillcs in the lunn ol'a STOP WORK ORDER and a fine o(up rn i'JA OQ,r Joy .against the vigl4nlr. IIc advLkll thin i copy nfilli slu0.•mmt may iW ST(I "V lu the RDE n.angan'Im ul':he DIA for nlsnr.0 ce�n aeNie I entiuUun. /III n,•rt•hylard nnJerlhep,enr`�r J�i In/1%t1u /1. t !Pa/nry thw Ntr iujunnrl/ow yrvviJrl(/u/^buvlr7s uw/1i,urd corrvcR l tJ//lciul rr.r uuly, pu,I41 writs in Uhi.1 urru, to Ar ruurylc4J A ril Y y ur IoI•n n/�hiuL (ilv ur I'nlrn: _ Ilnuln purvnivl.lh'n1e1 y .\W huriry (circle noel: I IL .uJ ,r(Ifrallh l. Ihuldul� Ilcp.Irinlcllt LCiIJ.'htlnclerk J. l'factric.Illu/lccrur :, I. Other I f4umbiny Impcclor 11„u.Icl YIr•wl: \ L• information and Instructions) tlr their� IIIplJyee�. ,Arson to the serve of anuthcr service underly Al cuanct of �Lus.l:huscus licneral n'�v lurrf is J:Ii1teJ as"Ileve In1ry P an tJ provide workers wmpensdbl n 1`urW.dli to❑tie+utuid, if . :,press or Inpl,:d. ural Jt written." Jralwn of other legal curry,or any two or more oycr,or the �n ewpJuyer Is defined as"an Innivi to rl, partnership,a intit t moo,:o Ic rise, and iluluJin the legal representatives ,a e�mslojeee.cj lHowcver he d ' ,,I the I;Iregomg engaged m a lumt earuem rshlp, ssoclatioo or other legal cnaty,employing ' P ecelver Jr dwells of tea se having p owner Jf a dwelling house having not mare than thra apanrnenu sAd nhvu`iion J"Jes�cpad work oerein'of lite nsu<h dwelling house dwelling IIUUid of another who employs perscris w Jo maintenancq. ' or on the grounds ter building appurtenant thereto shall not because of such employment be JeemaJ to lot an elnplJyer. �IGL chapter 152, 425C(6) also state*that"erfry state or local licensing agenc its the y shall ommOld the Iss for rtnflV Yl of Y IleeAse of permit to operate a business or le,eoa ilruct Will Will Ihegelgeinsurance ova agelregai any oypllcant nbo has not produefd acceP table+rldeace of Cuntp of its political subdivisions shall \JJiliondlly, �ICiL chapter I S2, i?SC(7)states"Neither the commonweaidr not any enter into any cIGL 01act Yor the parfomtun1i nroJbo thworke courtedlieptable 9 iJenee or'cuntVli ulee w ith the insurenea requirements of this elydpter Nava been p' �yyllcsn4 checking rho boxes Ihal apply to your situation and.if Pleatur till uut the workers' compensation altidavit completely,by less usher than the necessary.supply sub•eonmctar(s)n uno(t),aJlJfea�lee)aAd phone numbee(e)*long with their employes o ll Insurance, Limited Liability Companies(LLC)or Limited Liability Pannerahipa(if an LLC with r LLP employ members or imited are not required to carry workers' compensation IIUU suburince!to the DaparotmeN of Induastrial ld employees,a policy is requited ua advised that this affidavit may artmcnt of Also be sera to"Is su Yod date the uenedvIL rheUDJpdavit shoo \ccidents for conutrma►ion of ithat th eo coverage,t�Asion rot the permit of license If being req he fettleIle to tiv eery or town that the apD �*tioAa regarding the low ter if you ar+required to obtain Y workcra' InJusttia,,%ceidenta. Should you hav+any 4 Indusensation policy,plQOse call the Deparanant at the number listed below. self-insured compaaiea should ureter then s0if•i eruranee license number on the aporopri2to line. clry at'rows OtlleleU cd the applicant. pt:n.c M sure that'he you to 1�11 nutsinuhe even)Jt+Ot11cc of In estigations h,snro contact Yuuent has cegortling at the rush' Of Ilte affidavit for y applications in any given year,need only submit one .dcatio t indicating is ty or f die ff +arc ro rill in the p1 j)ut in thew n t th r whi:h will be used as ret'ercncc number, In addition,an app re lll bit lire),oust submit multiyle Vannio'and tiro astsPP s" ter marked by the city or town Inay be provided to the Policy ibt submit le lit'necessary)and under"Job Site Address"the applicant.+hnuld write"YII locations in Y town).",ll Copy of the ut7ldavit that has been Officially tor cramp' applicant a*proof that a valid a(AJuvit is tin file for ILtun Permits of licenses. A raw af to ally fidavit must be filled nut each y cdr. W crt a hy°r Permit owner w citizen is burn leave*�e.) p fyining 3 011 is NOTl requite d ot not �complete this business tmmarcial *rerun g uas110116, I het)ni:e of Investiyatiuro Iwuld like to dunk you in aJ"A" fur yuunoop+ration snJ should you hula.ny 4 )deuce du not hesintd to give us a:all. fhe U:parI it.11 s addre's, telephone and fax numbea The COmmnwea)d10f(t(ausaehusetta Department of Industrial Accidents O(8ee of IavesdQadens 600 Wigton Street Batton, MA 02111 ref, p 611.121E 1 00 ext 02 of 1.877 .mASSAFE y Vww.mass.jov/die CERTIFICATE OF LIABILITY INSURANCE ° 73/ "D°""""' 12/13/2010 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 NAME: The Driscoll Agency, Inc. PHONE I —' 93 Longwater Circle AIC No Eat:' - - 11N.610:781-681-6686 P.O. BOX 9120 AEMAIL OGRESS: ibd@driscollagency.com Norwell MA 02061 PRODUCER CUSTOMER ID N:3327 INSURERS AFFORDING COVERAGE NAICA INSURED INSURERA:Star Indemnity & Liability Company Building Maintenance Corp.14-15 Willard Street INSURER B:Excelsior Insurance Company11045 Peabody MA 01960 INSURERC:Everest National Insurance Co INSURERD:ACE Property & Casualty Insurance INSURERE:Peerless Insurance Company24198 INSURER F: COVERAGES CERTIFICATE NUMBER:733080832 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. INER ADDILSUBIR POLICY OFF POLICY EXP LTR TYPEOFINSURANCE2=RIM POUCYNUMBER (MWDDNYYYI IMMIID LIMITS A GENERAL LIABILITY WCSICON30017210 12/23/2010 12/23/2011 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TORENTED 50,000 PREMISES Ea accurrence $ CLAIMS-MADE IT]OCCUR MED EXP(Any one person) S5,000 PERSONAL S ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $2,000,000 JECT POLICY X PRO- X LOC $ S AUTOMOBILE LIABILITY BA 8730382 12/23/2010 12/23/2011 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) E ALLOWNEDAUTOS BODI LY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE X HIREDAUTOS (Per accident) $ X NON-0N/NEDAUTOS $ E C X UMBRELLA LAB X OCCUR 71CB000264-101 12/23/2010 12/23/2011 EACH OCCURRENCE $5,000,000 EXCESS UAB CLAIMS-MADE AGGREGATE $5,000,000 DEDUCTIBLE $ RETENTION $ $ D WORMERS COMPENSATION C46390969 12/23/2010 12/23/2011 X WC STATD- A AND EMPLOYERS'LIABILITY YIN M ANY PROPRIETORIPARTNERIEXECUTWE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? © NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 Ir yes,describe under DESCRIPTION OF OPERATIONSti E.L.DISEASE-POLICY LIMIT $500,000 E Installation Floater CBP 8732582 12/23/2010 12/23/2011 Job Site Limit $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,R mare space Is required) RE: Latitude Condominiums, 281 Essex Street, Salem, MA & all other projects in the city. Notice of cancellation provision is 30 days, except 10 days applies for non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Salem Massachusetts Attn: Public Properties Dept. 120 Washington Street, 3rd Floor AUTHORIZED REPRESENTATIVE Salem MA 01970 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD J CITY OF SM-EM, AASSACHUSETTS ftumm DEP.urnmNT 120 W.kiHLYGTON STIM, Ya FLOOR T)M (978) 745-9595 KIMBEALEY DRISCOLL FAX(978) 740-9M MAYOR Tlio.+uf ST.PMR is DIAECT04OPPLI3LICPROPEATY/8t: DLVGCONNISSIONEA Construction Debris Disposal AtHdavit (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 provision of MOL c 40, S 54; Building Permit Al is issued with the condition that the debris resulting from [his work shall be disposed of in a properly licensed w 8 111, S 150A. waste disposal facility as defined by MOL c The debris will be transported by: C yw%4 �oeff` M.I OL (name of hauler) The debris will be disposed of in (name o�lll�y) " V� liddre„of r + eiynamteofpermrt�ppficant 1=114� U.S. Roofing di ® a division of Building Maintenance Corp. m ® 11111116 Mill P.O. Box3118 � ars FI OOFING Peabody, MA 01961-3118 Telephone: (978) 532-6300 Fax: (978) 977-0803 CONTRACT The Owner(s)of the premises described below ("Job Address"), hereby contract with and authorize U.S. Roofing,a division of Building Maintenance Corp. ("Contractor"), to furnish all necessary materials, supplies, labor and workmanship, and to install, construct and place improvements at said Job Address, according to the following specifications, terms and conditions: 1. Owner's Name: Museum Place Condominium Trust C/o Gemini Property Management, LLC 89 West Main Street Merrimac, MA 01860 2. Job Address: Museum Place, 17 Central St., Salem, MA 3. Specifications: Contractor agrees to perform the following services in a good and workmanlike manner: ` Dismantle, remove from roof and dispose of two (2) existing roof decks in place; Cost also includes the crane expenses necessary to lift any new deck material to the roof on the last day of the crane being planned to be onsite as part of the roof replacement Remove proposed EPDM sections of roof down to exposed wood substrate, lower to dumpster with crane and dispose of in a legal landfill Prepare the existing roof system to remain for the new roof according to Carlisle specifications Provide and mechanically-attach 1" PolyISO roofing board and .5" PoIyISO tapered roofing board over all cleaned areas of roof according to Carlisle specifications Fully-adhere Carlisle's .060 Adhered EPDM system over newly installed insulation (full sheets to reduce seams) and up all abutting walls Flash all applicable walls, roof drains and all applicable penetrations according to Carlisle specifications Fabricate and install at all thresholds, 16-ounce copper counterflashing according to Carlisle specifications (door thresholds work to be coordinated and performed by others) U.S. Roofing will acquire all permits and schedule inspections U.S. Roofing would 'install the roofing system and dispose of all debris in accordance with all local, state, and federal regulations - Only cut and/or remove as much existing roofing materials as can be completely re- rooted that same day. Make watertight night tie-ins on a daily basis - Provide for a safe, non-disruptive job-site ensuring appropriate access and disposal lanes. - Work environment to be clean and safe for roof mechanics, building employees and public Provide Contractor Warranty • 4. Payment Terms: The total cost of the contract is$ 19,480.00 Payment shall be rendered in the following manner: 50% ($9,740.00) Due upon delivery of materials and commencement of work 45% ($ 8,766.00) Due upon 100% successful completion of all work 5% ($974.00) Balance to be paid 30 days from successful completion of all roof work and delivery of manufacturer's roof warranty S. Attorney's Fees: In the event of default, the Owner shall pay costs for collecting amounts owing including, without limitation, court costs, expenses and reasonable attorney's fees, in addition to any sum that the member may be called on to pay. 6. Entire Agreement: This contract constitutes the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. The Owner agrees that Contractor has made no statements, promises, commitments or representations not contained herein. 7. Modification: Other than that required as a result of paragraph 4 above,any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if evidenced in writing signed by each party or an authorized representative of each party. S. Unforseen Circumstances: Contractor is not liable for delays due to weather, strikes, accidents, acts of God or other circumstances arising out of causes beyond its reasonable control and without its fault or negligence. Contractor is not liable for material increases due to fuel charges, petroleum based and metal products. Price increases of 6-8% per month in 2011 have been forecasted,therefore pricing from our manufacturers is based on when the material can be delivered, not upon when ordered. we reserve the right to adjust material prices accordingly or make every attempt to deliver materials within the quoted pricing timeframe. 9. Governing Law: It is agreed that this agreement shall be governed by, construed, and enforced in accordance with the laws of the Commonwealth of Massachusetts. IN WITNESS WHEREOF, the parties have signed their names hereto: Date: 9-6-2011 Date: 9/-7 s Roofing, by its agent Museum Place Condo Trust: Willard H. Murray 2 7817628974 NATL.MAINT. 202 P02/14 AUG 17 '05 07:20 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info®nmservice.biz August 17,2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr.Thomas St. Pierre Building Inspector RE: Unit#1 Museum Square P04215 Dear Mr. St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811,being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. f � �0.t► QiAAlO �y PE 422$�h1�,,;,.. CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 P03/14 AUG 17 '05 07:20 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762.8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem,MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#2 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811,being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge,the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. y 3JERALO �a WADLN j CC: James J. Welch Co., Inc. HEATING-AIR CONDITIONING* REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 PO4/14 AUG 17 '05 07:21 NATIONAL MAINTENANCE AND SERVICE CORP, P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17,2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#3 Museum Square P04215 Dear Mr, St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have bow complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. or r;. YQ. w , ►w PE# CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING•REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 P05/14 AUG 17 '05 07:21 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St.Pierre Building Inspector RE: Unit#4 1 Museum Square P04215 Dear Mr. St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811,being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. PE CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL. MAINT. 202 P06/14 AW 17 '05 07:21 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem,MA 01970 ATT: Mr.Thomas St. Pierre Building Inspector RE: Unit#5 Museum Square P04215 Dear Mr. St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811,being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. ♦3a�H i "'�s;� Yo fw�a I all raid a PE CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 PO?/14 AUG 17 '05 07:21 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: Info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem,MA 01970 ATT:Mr. Thomas St. Pierre Building Inspector RE: Unit#6 Museum Square P04215 Dear Mr. St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. • CIEBALD W LLA Gerald PE CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING•REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 P08i14 AUG 17 '05 07:22 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem,MA 01970 ATT:Mr. Thomas St. Pierre Building Inspector RE: Unit#7 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. Lf ku Yo KAw szer<t `' Ge ' PE#22 ti'r� 9:i-Irk} �yZssiiytilC� CC: James J. Welch Co., Inc. HEATING-AIR CONDITIONING-REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 P09/14 AUG 17 '05 07:22 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem,MA 01970 ATT:Mr. Thomas St. Pierre Building Inspector RE: Unit#8 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, i Gerald Kawadler Massachusetts Registration number 22811,being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge,the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. GERALD DLER - ZZB11 ' PE • �ttr CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 P10i14 AUG 17 '05 07:22 NATIONAL. MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem,MA 01970 ATT:Mr.Thomas St.Pierre Building Inspector RE: Unit#9 Museum Square P04215 Dear Mr. St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. a or yerruw La 22611 al PE r CC: James J.Welch Co., Inc. HEATING•AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 P11i14 AUG 17 '05 07:22 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#10 Museum Square P04215 Dear Mr. St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. a� Y taut . Geral or PE �sTr.•%, CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING•REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 P12/14 AUG 17 '05 07:23 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769,5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info®nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem,MA 01970 ATT: Mr. Thomas St.Pierre Building Inspector RE:Unit#11 Museum Square P04215 Dear Mr. St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. y In a WAoLIa 1 Geral dW11 do t PE `� CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING•REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 P13/14 AUG 17 '05 07:23 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769.5420 FAX; (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem,MA 01970 ATT:Mr. Thomas St. Pierre Building Inspector RE: Unit#12 Museum Square P04215 Dear Mr. St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code,I Gerald Kawadler Massachusetts Registration number 22811,being a Registered Professional Engineer hereby certify that the heating, ventilWag and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. Yo ' 22811 r r Gerald .✓:tom i PE CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING-REFRIGERATION ENERGY MANAGEMENT 7817628974 NATL.MAINT. 202 P14/14 AUG 17 '05 07:23 NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info eOnmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: A& Thomas St. Pierre Building Inspector RE: Unit#13 Museum Square P04215 Dear Mr. St.Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811,being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge,the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. Y LC . i. PE#22 ''� j • "' CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING•REFRIGERATION ENERGY MANAGEMENT NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 - 2 4 2 - 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 - 7 4 2 4 August 15, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for the overall building Permit# Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, the condominiums as constructed at 17 Central Street are in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. * ith the exception of punch list items. Sinc rely NES KIN FRENCH ARCHITECTS, INC. EDe�'i Q �.d W' f W. e Registe d Architect �� y ARCHITECTS PRESERVATION PLANNERS DEVELOPN4ENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E CHAR LESTOWN M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 2 4 2 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 1 Permit# 77 ZW¢ at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 1 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. * with the exception of punch list items. Sincere , S FRE CH ARCHITECTS, INC. D Atr�grr nch ( ' >° aster Architect NO.5758 GVALUSMVIA o � ARCHITECTS • PRESERVATION PLANNERS DEVELOPMENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 - 2 4 2 - 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 - 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 2 Permit# 5 g at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 2 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. JReered exception of punch list items. FREN ARCHITECTS, INC. e h N0.8758 chitect awwwm r Is �J �G l}/OF" ARCHITECTS • PRESERVATION PLANNERS DEVELOPMENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 - 2 4 2 - 7 4 2 2 L i n d a C N e s h a m k i n A I A f a x 6 1 7 - 2 4 2 - 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 3 Permit# g S 9 — 2004 at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium#3 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. wi the exception of punch list items. Sincere y, NES FRENCH ARCHITECTS, INC. 4�� q�0yi . Fri ch .�`o't►�'w. RgFry �� egistere Architect No 5758 w a� 0 1A P ARCHITECTS • PRESERVATION PLANNERS DEVELOPMENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 - 2 4 2 - 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 - 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 4 Permit# at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 4 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. * . the exception of punch list items. Sincerel , NES FRENCH ARCHITECTS, INC. ench to d Architect w ARCHITECTS • PRESERVATION PLANNERS [DEVELOPMENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 - 2 4 2 - 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 - 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 5 Permit# at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 5 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. * with the exception of punch list items. Since ly, S F CH ARCHITECTS, INC. o'g'� aftcy�T� W. Fre h stered chitect C11 No 5758 VA c'7 Of ARCHITECTS PRESERVATION PLANNERS DEVELOPMENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 2 4 2 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 6 Permit# $6 at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 6 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. * 'th the exception of punch list items. Sincer y, NES FRE CH ARCHITECTS, INC. ;rx"�L tere Architect No caaa►cs�oM�i, � MA G 0 t��G ARCHITECTS PRESERVATION PLANNERS DEVELOPMENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W . F r e n c h , A I A t e l 6 1 7 - 2 4 2 - 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 - 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT? Permit# at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 7 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. * ith the xception of punch list items. Sincerely, SHAM F NC ARCHITECTS, INC. EO Af��h� T `r Frenc stered hitect No.5758 3 INA ' ARCHITECTS • PRESERVATION PLANNERS • GE`•JELOPAAEN CONSULTANTS NESHAIVIKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 2 4 2 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 8 Permit# uwl at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 8 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. with t exception of punch list items. N� Sincerel , l NES KIN F NCH ARCHITECTS, INC. 5'r nch e ter Architect 0 No.57 � ! � C�1RAlEST01N� "� i; �� l FW" `S ' ARCHITECTS PRESERVATION PLANNERS DEVELOPMENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S 0 U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h A I A t e l 6 1 7 2 4 2 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 2 4 2 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 9 Permit# �G5 - Zoo y at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 9 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. with th exception of punch list items. Sincerely, S FRENC ARCHITECTS, INC. Fre h w i�Cy�r�c Re stered chitect •i►+ Fti� ' No.-5758 y 0 � s ARCHITECTS • PRESERVATION PLANNERS DEVELOPMENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W . F r e n c h , A I A t e l 6 1 7 - 2 4 2 - 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 - 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 10 Permit# g;416 'Zcv`{ at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 10 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. * ith t exception of punch list items. Sincerely, S KIN F NCH CHITECTS, INC. `� rF �• renc � �® ��a. FRFti egistered Ar hitect '� 0 t+b.57513 �t ►ofH ARCHITECTS PRESERVATION PLANNERS DEVELOPMENT CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 - 2 4 2 - 7 4 2 2 L i n d a C N e s h a m k i n , A I A f a x 6 1 7 - 2 4 2 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 11 Permit# o G — Zara at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 11 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. * ith the e ception of punch list items. Sincerely, SHAM F CH CHITECTS, INC. rench st ed Ar itect ��G�.�'wRRF4, 17) No.575U kk� F " ARCHITECTS + PRESERVATION PLANNERS DE`•JELOPNAENT CONSULTANTS NESHAIVIKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W F r e n c h , A I A t e l 6 1 7 - 2 4 2 - 7 4 2 2 L i n d a C N e s h a m k i n , A I A r a x 6 1 7 - 2 4 2 - 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 12 Permit# at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 12 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. * with th exception of punch list items. incerely, HAM N ARCHITECTS, INC. Fre tered chitect r ARCHITECTS PRESERVATION PLANNERS DEVELOPNIEN7 CONSULTANTS NESHAMKIN FRENCH ARCHITECTS , INC . 5 M O N U M E N T S Q U A R E C H A R L E S T O W N M A 0 2 1 2 9 J o h n W . F r e n c h , A I A t e l 6 1 7 2 4 2 7 4 2 2 L i n d a C N e s h a m k i n A I A f a x 6 1 7 - 2 4 2 7 4 2 4 August 16, 2005 Building Commissioner Zoning Officer Thomas St. Pierre 120 Washington Street Salem, Mass. 01970 Re: Final Certification for UNIT 13-14 Permit# G q • S}D Z�q at the Residences @ Museum Place 17 Central Street Salem, MA 01970 Dear Mr. St. Pierre, This is to certify that, to best of my professional judgment and personal knowledge, Condominium# 13-14 has been constructed at 17 Central Street in conformance with the plans and specifications prepared by this office as amended, and are in conformance with the present building code of the Commonwealth of Massachusetts and the zoning by-laws of the city of Salem. with the ception of punch list items. ncerely, HAM NC ARCHITECTS, INC. s Fren Regi ered chitect . ARCHITECTS PRESERVATION PLANNERS DEVELOPMENT CONSULTANTS 74520 40°6 pq Certificate No: 859-2004 Building Permit No.: 859-2004 Commonwea th of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the RESIDENCE located at Dwelling Type 0017-19 CENTRAL STREET in the CITY OF SALEM ----------------------------------------------------------------------------- --------------------------------------------------------------- ---- Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY UNIT#3 This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires . ........ ................. -- -- -- ... unless sooner suspended or revoked. Expiration Date ---- __ - -- - - --- -------- Issued On:Fri Nov 17,2006 ---- -- - - ----------- --- ----------_----.--.- --- GeoTMS®2006 Des Lauriers Municipal Solutions,Inc. ----------------------------- __---------___-_--__-__------- CITY OF SALEM BUILDING PERMIT 0017-19 CENTRAL STREET 859-2004 GIS#: 531 COMMONWEALTH OF MASSACHUSETTS Map: 35 Block: CITY OF SALEM Lot: 0236 Category: 102 New Attached Co Permit# 8592004 BUILDING PERMIT Project# JS-2004-001254 Est.Cost: $0.00 Fee Charged: $0.00 Balance Due: $.00 PERMISSION IS HEREBY GRANTED TO: Const.Class: Contractor. License: Expires Use Group: James J.Welch&Co.Inc. General Contractor-CS 067486 Lot Size(sq.ft.): 19932 Owner: CHARING CROSS REALTY Zoning: B9 Units Gained: Applicant: James J. Welch&Co. Inc. Units Lost: AT. 0017-19 CENTRAL STREET Dig Safe#: ISSUED ON. 20-Apr-2004 AMENDED ON. EXPIRES ON: 20-Oct-2004 TO PERFORM THE FOLLOWING WORK: 859-2004 REFER TO PERMIT 856-2004 FOR ALL FEES *UNIT 3 TJS POST THIS CARD SO IT IS VISIBLE FROM THE STREET Electric Gas Plumbing Building Underground: Underground: Underground: Excavation: Service: Meter: Footings: Rough: Rough: Rough: Foundation: Final: Final: Final: Rough Frame: Fireplace/Chimney: D.P.W. Fire Health Insulation: Meter: Oil: Final: House# Smoke: Treasury: Water: Alarm: Sewer: Sprinklers: THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Signature: Fee Type: Receipt No: Date Paid: Check No: Amount: BUILDING REC-2004-001337 20-Apr-04 24471 $0.00 IIJ6 .00 GeoTMS®2006 Des Lauriers Municipal Solutions,Inc. , Commonwealth of Massachusetts Citv of SalemIF 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5841 Return card to Building Division for certificate of Occupancy Permit NO. B-16-1007 PERMIT TO BUILD FEE PAID: $44.00 DATE ISSUED: 9/12/2016 This certifies that RUBIN REALTY TRUST RUBIN DEAN/ROBIN TRACY TRS has permission to erect, alter, or demolish a building 17-U1.CENTRAL STREET Map/Lot: 350236.801 as follows: Repair/Replace FOR RESIDENCE @ MUSEUM PLACE CONDOS.: REMOVE STAIR ON SIDE OF BUILDING. (EXISTING STAIRS ARE PRECAST CONCRETE. REPLACE STAIRS WITH GRANITE STEPS.) 1 Contractor Name: GARY ABBOTT DBA: ABBOTT CONSTRUCTION & LANDSCAPING LLC Contractor License No: CS-032850 A D/ 9/12/2016 Building Official' Date This permit shallbe deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.The Building Official may grant one or more extensions not to exceed six months each upon written request.. v - - . All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. - All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. - a i This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures.by the Building and Fire Officials are provided on this permit. y HIC#: 176206 'Persons contracting with unregistered contractors do not have access to the guaranty fund'(as set forth in MGL c.142A).' Restrictions: i Building plans are to be available on site. All Permit Cards are the property of the PROPERTY OWNER. - Commonwealth of Massachusetts r � City of Salem 1.' 9 120 Washington St,3rd Floor Salem,MA 01970(978)745-9595 x5841 Return card to Building Division for certificate of Occupancy - - Structure CITY OF SALEM BUILDING PERMIT PERMIT TO BE POSTED IN THE WINDOW Excavation t Footing 1 d INSPECTION RECORD _ Foundation Framing #' Mechanical J, S Insulation INSPECTION: BY 1- DATE i Chimney/Smoke Chamber Final L fOA Plumbing/Gas } Rough:Plumbing Rough:Gas Final. - .1 Electrical I - Service `y Rough Final Fire Department r J Preliminary - Final , Health Department a Preliminary 1 Final EjF - e CITY OF SALEM ROUTING SLIP NEW CONSTRUCTION CERTIFICATE OF OCCUPANCY LOCATION: /7-/9 -C<r7Y4 C St- DATE APPLICANT: ASSESSORS FRANK KULIK if .of L �� uDA'I'E: ( s (93 Washington St(eet) CITY CLERK / CHERYL LAPOINTE ! /C!" ' DATE: /y27�S (93 Washington Street) PUBLICE SERVICES BRUCE THIBODEA DATE:��S (120 Washington Street "F WATER d DOTTIE THIBODEAU DATE: (120 Washington Street)4" o r CROSS CONNECT SUPERV O BRIAN THIBODEAU DATE: d a" m� (5 Jefferson Avenue) PLANNINGp� � � t VALERIE GINGRICH /li�,.,,iJ DATE:_ (120 Washington Street) 3`a Floor CONSERVATION COMMISSION �11 FRANK TAORMINA DATE: (120 Washington Street)3`d Floor ELECTRICALp JOHN GIARDI DATE: (48 Lafayette Street) FIRE PR n ERIN GRIFFIN DATE: (29 Fort Avenue) HEALTH JOANNE SCOTT JG DATE: / (120 Washington et)4ih Floor BUILDING THOMAS ST. PIERRE DATE: (120 Washington Street) 3`d Floor Certificate No: 861-2004 Building Permit No.: 861-2004 Commonwealth of Massachusetts City of Salem Building Electrical Mechanical Permits This is to Certify that the CONDOMINIUM located at --------------------Dwell: ing Type 0017-19 CENTRAL STREET in the CITY OF SALEM .--------------------------------------------------------------------- Address Town/City Name IS HEREBY GRANTED A PERMANENT CERTIFICATE OF OCCUPANCY UNIT 5 This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires ----------------------------- ------ ------- unless sooner suspended or revoked. Expiration Date ------------------------------------—... ... ----___-------__ Issued On:Thu Aug 18,2005 ----------------------------------- - GeoTMS62008 Des Lauders Municipal Solutions,Inc. ----------------=-------------------------------------------------------------- n YSOYE AO t� CITY OF SALEM BUILDING PERMIT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#I Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. Your GERALD ER ?. r r wadlers , PE #229+71,y;; e� , CC: James J. Welch Co., Inc. HEATING •AIR CONDITIONING • REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#2 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. Via;,- Y HERALD WADLER 22 ra � filar �•�,� PE# 1 CC: James J. Welch Co., Inc. HEATING •AIR CONDITIONING • REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#3 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. cawr ' GERALD W 22811 n Ge d er,� PE CC: James J. Welch Co., Inc. HEATING •AIR CONDITIONING • REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit #4 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. Y GERALD DLER PE 4 �81 CC: James J. Welch Co., Ina p° HEATING •AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#5 Museum Square P04215. Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. Yo GERALD a 22811 o & raid ¢¢ PE Aa - , CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING • REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit #6 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. . ai% y ,, GERALD . WA Gerald �Iaii PE CC: James J. Welch Co., Inc. �rc 'Itia" HEATING •AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#7 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. bl C4 q%p� Yo , , ' GERALD KAW 228I1 Ge d �1 at erf� PE#228 CC: James J. Welch Co., Inc. HEATING •AIR CONDITIONING • REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit 48 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. 41 Y GERALD # DLER ` .„µ? 22811 ' erald PE 422 CC: James J. Welch Co., Inc. HEATING •AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#9 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. a Y r* YEERALD KA LER _:i `a 22811 0 "i eralcT' ad}gr n a PEyTJr , at: CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING • REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT:.Mr. Thomas St. Pierre Building Inspector RE: Unit #10 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. Yo 'GERALDSL - 22811 " ' Geral PE 281;; . T G a CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING • REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT;Mr. Thomas St. Pierre Building Inspector RE: Unit#11 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. ar Y r D $ KAWADLER Geral dol' PE `liar$; CC: James J. Welch Co., Inc. Faa HEATING •AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit#12 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. it aF Yo , 22811 Gerald PE CC: James J. Welch Co., Inc. HEATING•AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT NATIONAL MAINTENANCE AND SERVICE CORP. P.O. BOX 135 61 ENDICOTT STREET BUILDING 23 NORWOOD, MA 02062 (781) 769-5420 FAX: (781) 762-8974 E-MAIL ADDRESS: info@nmservice.biz August 17, 2005 City of Salem Building Department 120 Washington St. Salem, MA 01970 ATT: Mr. Thomas St. Pierre Building Inspector RE: Unit #13 Museum Square P04215 Dear Mr. St. Pierre: In accordance with the requirements of paragraph 116.0 of 780 CMR of the Massachusetts Building Code, I Gerald Kawadler Massachusetts Registration number 22811, being a Registered Professional Engineer hereby certify that the heating, ventilating and air conditioning systems have been installed in accordance with the plans and specifications. This letter shall serve as a Final Affidavit for the above referenced building and that to the best of my knowledge, the provisions of the building code have been complied with and the area of work meets all the necessary requirements for the proposed use and occupancy. Y ��yKts �D .� ;.. ER ii 4i.v Ge ald orf rv� PE#221f CC: James J. Welch Co., Inc: HEATING •AIR CONDITIONING• REFRIGERATION ENERGY MANAGEMENT