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30 PROCTOR ST - BUILDING INSPECTION \ ^ The Commonwealth of Massachusetts �1 Board of Building Regulations and Standards CITY J Massachusetts State Building Code,780 CMR, 7"edition ReOvFeSALEM d✓nary v ( Building Permit Application To Construct,Repair,Renovate Or Demolish a 1, 2008 o One-or Two-Family Dwelling This Section For Official Use Only Building Perrait Numbe Date Applied: r� Signature: �cp .b /� ✓, /9J f 0 Building Commissioner/Idgrector of Buildings Date SECTION 1: SITE INFORMATION 1.1 Propeq�5 Address: 1.2 Assessors Map&Parcel Numbers r�r�dr I.Ia Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Cl Private❑ Zone: Outside Flood Zone? Check if yes❑ Municipal❑ On site disposal system ❑ SECTION 2: PROPERTY OWNERSHIP` 2.1 Owner`of Record: t s3©�nDf�� t Name tint), Address for Service: ins Signature Telephone LC?k SECTION 3:DESCRIPTION OF PROPOSED WORIe(check all that apply) New Construction❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) ❑ 1 Alteration(s Addition ❑ Demolition ❑ 1 Accessory Bldg. ❑ Number of Units Other ❑ Specify: Brief Description of Proposed Work: mQ — F1 0 v s ��leo 0 4 �v o z Q \r v Sim �Ct Tx uxxn� 2k3�kv�n c c�,i v ye c 41c s t SECTION 4:ESTIMATED CONSTRUCTIO COSTS Item Estimated Costs: (Labor and Materials Official Use Only 1. Building $ tee, 20 — 1. Building Permit Fee: $ Indicate how fee is determined: 2.Electrical $ ❑Standard City/Town Application Fee ❑Total Project Costa(Item 6)x multiplier x 3.Plumbing $ 2. Other Fees: $ 4.Mechanical (HVAC) $ List: 5. Mechanical (Fire $ Suppression) Total All Fees: $ Check No._Check Amount: Cash Amount: 6.Total Project Cost: $ Sac)o— 0 Paid in Full 0 Outstanding Balance Due: SECTION 5: CONSTRUCTION SERVICES 5.1 Licensed Construction Supervisor(CSL) 1 p!�s \\\s4yLll y License Number Exp ation ate Name of CSL-Holder Ct�A_Oly�s 10 S Ff r n`,��5�\ List CSL Type(see below) rQ{� A `'\ Type Description U Unrestricted(up to 35,000 Cu.Ft.) R Restricted 1&2 Family Dwelling Signature M Masonry Only 7$ -DL-7 Z RC Residential Roofing Covering Telephone W S Residential Window and Siding SF Residential Solid Fuel Burning Appliance Installation D Residential Demolition 5.2 Registered Home Improvement Contractor(HIC) HIC Company Name or HIC Regis�tr�ant N"acme - Registration Number S Mkt PCs\.\�2)& ��w�(�PV. ,,6 Add \A'31k--\7D10 78I-Io3\ -4 Expiration ate Sig6ftirev Telephone SECTION 6:WORKERS' COMPENSATION INSURANCE AFFIDAVIT(NLG.L.c. 152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... No...........❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERNUT I, �� , as Owner of the subject property hereby authorizJ- >- Z yZ y behalf,in all matters relaIV1, o wo�r authorizedy this building permit application. ! Si alure of Owner Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION I, ,as Owner or Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and behalf. Print Name Signature of Owner or Authorized Agent Date (Signed under the pains and penalties ofperjury) NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program and Construction Supervisor Licensing(CSL)can be found in 780 CMR Regulations 11 O.R6 and I IO.R5,respectively. 2. When substantial work is planned,provide the information below: Total floors area(Sq.Ft.) (including garage,finished basement/attics,decks or porch) Gross living area(Sq.Ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"maybe substituted for"Total Project Cost" A � The Commonwealth of Massachusetts Department of Industrial Accidents Office 0110YOsagadons -- 600 Washington Street, ?'*Floor Boston,Mass. 02111 Workers Compensation Insurance Affidavit: Buildin lumbing/Electrical Contractors A�pficant information: �\�\ Please PRINT legibly name: 1019.v\y\\S \\\�I.Y\ S. addres�s'� pn `, city \\�,9sc�Y��(�y�R \`^/ estate: ` \,�_ p zip: \\�4S phone# work site location(full address) 50 `f fU` '�t�(— Sl — Saeh-\ —Oke,1Q ❑ I am a homeowner perfomling all work myself. Project Type: ❑New Construction®Ttemodel ❑ I amsoleproprietor and have no one working in aapa�ity �❑TBuilding Addition <Jo_+-enaanemp er providing workers' compensation for my employees working on this job. companv name: ('(�2`1'F� rto\r'NV13Ca c1 \\6 address c-a Mdsr�11L-\l7Cr�S�\� (�t�.0 city: \a\ \e\11Iw p��A� Ol�� phone#• f l?21 14p�1ya�7 y insurance ca\ld ��,�P � k_4 tl-P_ \VN�, lm1icv# ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: address: city. phone M insurance co. Polity# company name: address: city: phone M insurance co. policy# JAtmch additional sheet ifnecessary Failure to secure coverage w required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify unafer the pains and penahies of perjury that the information provided above is true and correct Signatu 1 G Date I rd I C Printname Phone ')'R 0 official use only do not write in this area to be completed by city or town official city or town: permit/liceme# ❑Building Department ❑Licensing Board ❑check if immediate response is required []Selectmen's Office ❑Health Department contact person: phone#; ❑Other (re".d St2caz) 0 ACORD,,, CERTIFICATE OF LIABILITY INSURANCE 3 DATE 17/17/MIDDIYYYY) 2010 PRODUCER Phone: 508-651-7700 Fax: 508-653-8089 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eastern Insurance Group LLC -Commercial Lines ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 233 West Central Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Natick MA 01760 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:National Grange Mutual 14788 Presto Painting & Construction CO. INSURERB:Safety Insurance Com an 8 Yorkshire Road Marblehead MA 01945 INSURER c:Granite State Insurance Co. INSURERD:Max Specialty Insurance Cc INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR OD' POLICY EFFECTIVE POLICY EXPIRATION LTR IINSRC TYPECIFINSURANCE POLICYNUMBER ATE MMIDD DATE M I D/YY LIMITS A GENERAL LIABILITY VIPOS9800 11/15/2009 11/15/2010 EAGHoccuRRENCE $1 000 000 X COMMERCIALGENERALLIABILITV PREMISES Ea oc Lo, $SQQ 0QQ CLAIMS MADE OOCCUR MED EXP(Anyone person) $10 OOO PERSONAL B ADV INJURY $ 1 GOO 000 GENERALAGGREGATE $2 000 000 G _AGGREGATELIMITAPPLIESPER: PRODUCTS-COMPIOPAGG $2 000 000 POLICY X PRO- LOC $ AUTOMOBILE LIABILITY G203010 4/5/2009 4/5/2010 COMBINED SINGLE LIMIT ANVAUTO (Eaaccident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULEDAUTOS (Per person) X HIREDAUTOS BOr accident) $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Peraccidenp GARAGE LIABILITY AITOONLY-EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTOONLY: AGG $ D EXCESSIUMBRELLALIASILITY MAX113100038133 8/13/2009 8/13/2010 EACH OCCURRENCE $ 2 000 000 X OCCUR 11 CLAIMS MADE AGGREGATE $2 OOO 000 DEDUCTIBLE X RETENTION SS,000 $ G WORKERS COMPENSATION AND WC9886432 12/12/2009 12/12/2010 1 ORY LATIis ER _ EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? E.L.yes,describe under DISEASE-EA EMPLOYEE $ If SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The Workers' Compensation certificate will be issued from the carrier, coverage is in effect. JOB: 30 PROCTOR STREET CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED City Of Salem BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE Attn: Public Properties Dept. CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO 120 Washington Street, 3rd Fl SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON Salem MA 01970 THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATNE QHn-` ACORD 25(2001108) 1 ©ACORD CORPORATION 19 88 CITY OF S�1LE1�1, l'LISSACHL?SET'I S BUILDL\GDEPAR" EENT P 130 WASHNGTON STREET,3" FLOOR TEL. (978) 745-9595 FAX(978) 740-9846 KINIBERLEY DRISCOLL b1AYOR THO.%W ST.PtEnE DIRECTOR OF PUBLIC PROPERTY/BUILDIING CONLVISSIONER 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: (name of huttl r) The debris will be disposed of in � (name facility) k °40c anln Alm ress of facility) 4sign, f permit applicant 13ll-, Ili date Jcbnsat7.Jix Ian' . r thl. massacbuseltc- Department of Public Safer Board of Buildin,; Regulations and StandurAs Illt Construction Supervisor Specialty License I License: CS SL 100452 I Restricted to: RF,WS IOANNIS MAKRIS 8 YORKSHIRE ROAD MARBLEHEAD, MA 01945 Pa Expiration: lf27t2012 (aunniiwi'mer Tr#: 100452 t j Boar of o�"I`i i�'g' `egula'fioT(se d'` �darrJs { HOME IMPROVEMENT CONTRACTOR Registration: 153422 Expiration: 11/30/2010 Tr# 280631 , { Type: Private Corporation PRESTO PAINTING AND CONSTRUCTIONCOMPANY LOANNIS MAKRIS 317 B HAVERHILL STREET ROWLEY,MA 01969 Administrator e 4 I J1 1 t t t i a 5 a A �i5�� 1W8t 8 Yorkshire Road Marblehead,Ma 01945 (978)356-5419— (866)PRESTO-7 HIC#153422- - - CSSL #100452 FID #2 0-5 79488 9 www.prestoroofin�.com PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT. Chet F'Amico 30 Proctor Street 30 Proctor Street Salem Salem, Ma DATE OF PROPOSAL: (978)361-7199 cell March 17, 2010 Having visited and examined the site of the proposed project and being familiar with the conditions relating to the construction, including the availability of the materials and labor, Presto Painting&Construction hereby proposes to furnish all materials, labor, equipment and supervision required and to complete the work in accordance with this contract document. ROOFING: House & Garage 1. Strip off existing roofing shingles of house and garage, dispose of properly& legally. 2. Inspect existing roof deck boards; inform customer of any rotted. 3. Install 6 feet of Grace Ice&Water Shield to perimeter of roof to prevent ice backups. 4. Install Titanium 30 roof underlayment. 5. Install aluminum drip edge to all perimeters of roof areas. 6. Install new CertainTeed Landscape Architectural 30 year asphalt roofing shingles COST: $5,200.00 INSURANCES. FULL PROPERTY AND LIABILITY INSURANCE IS THE RESPONSIBILITY OF PRESTO PAINTING&CONSTRUCTION INSURED UNDER NATIONAL GRANGE MUTUAL INSURANCE policy#MP089800 expiration 11/15/10 FULL WORKERS COMPENSATION COVERAGE INSURED UNDER GRANITE STATE INSURANCE COMPANY policy#WC9886432 expiration 12/12/10 (insurance certificates are available upon request) (construction safety program outline is available upon request) PAYMENT SCHEDULE: Payments are to be made as follows: One half upon beginning and balance including any extras in full when work is complete. OTHER COMMENTS: IEE certified for EPA Renovator,Repair&Paint(RRP). OSHA certified. Project will be performed under the state requirements& requirements of EPA. Presto may withdraw this proposal if not accepted within ninety(90)days. 1 All materials are guaranteed to be as specified. Care will be taken during the progress of the work, all surfaces needed,will be covered to prevent from any damage or harm occurring during the work day. Work area will receive a complete inspection at the end of each workday and will be swept and cleaned daily as found. All surfaces will be prepared and finished in a manner that meets professional standards. Presto Painting&Construction will obtain any and all necessary construction related permits, any owner who secure their own construction permits or deal with unregistered contractors shall be excluded from access to the Guarantee Fund. No work shall begin prior to acceptance of proposal.No verbal agreement is accepted ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- NOTE: All home improvement contractors and subcontractors shall be registered and any inquiries about a contractor or subcontractor relating to registration should be directed to: Director,Home improvement Contractor Registration One Ashburton Place Room 1301 Boston,Ma 02108 (617)727-8598 ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- ----- Do Not Sign This Contract If there Are Any Blank Spaces ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Authorized Signature "'' ' Ioannis Makris Presto Painting&Construction Signature �t Chet i,o ' 30 Proctor Street, Salem Date of Acceptance 1 V, %1 Q "HIGHEST QUALITY AND CLEANLINESS--YOUR PRODUCT OUR BUSINESS" NOTICE OF CANCELLATION: Homeowner may cancel this transaction without penalty or obligation, within three business days from the date of acceptance. If you cancel, any property traded in, any payments made to you under the contract or sale and any negotiable instruments executed by you will be returned within ten business days following receipt of cancellation notice and any security interest arising out of the transaction will be null. If you cancel you must make available to contractor at you residence, in substantially as good condition as when received, any goods delivered to you under this contract or you may wish to comply with the instructions of the contractor regarding the return shipment of the goods at your expense and risk. If you do make the goods available to the contractor and the contractor does not pick them up within twenty days of the date of cancellation you may retain or dispose of the goods without any further obligation. If you fail to make goods available to contractor, or if you agree to return the goods and fail to do so, then you remain liable for performance of all obligations under this contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any written notice to Presto Painting& Construction at 8 Yorkshire Road, Marblehead, MA 01945 no later than midnight of (date). I hereby cancel this transaction. Homeowner's signature: Date: i I i i